Claims Examiner
5 months ago
Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.
A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work.
Great Place to Work®
Most Loved Workplace®
Forbes Best-in-State Employer
Claims Examiner - Workers Compensation (CT/MA/NH/RI/VT)
- Claims examiner
- Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands?
- Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations.
- Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
- Leverage Sedgwick’s broad, global network of experts to both learn from and to share your insights.
- Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.
- Enjoy flexibility and autonomy in your daily work, your location, and your career path.
- Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.
- PRIMARY PURPOSE OF THE ROLE: We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.
- ARE YOU AN IDEAL CANDIDATE? To analyze workers compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
- ESSENTIAL RESPONSIBLITIES MAY INCLUDE
- Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
- Negotiating settlement of claims within designated authority.
- Communicating claim activity and processing with the claimant and the client.
- Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.
- QUALIFICATIONS
- Education & Licensing: 3 years of claims management experience or equivalent combination of education and experience required.
- High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.
- Professional certification as applicable to line of business preferred.
- Licensing / Jurisdiction Knowledge: NY, MA,CT,RI,NH
- TAKING CARE OF YOU
- Flexible work schedule.
- Referral incentive program.
- Opportunity to work in an agile environment
- Career development and promotional growth opportunities.
- A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
- Work environment requirements for entry-level opportunities include
- Physical: Computer keyboarding
Auditory/visual: Hearing, vision and talking
Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.
- #claimsexaminer
- As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in _this job posting only, the range of starting pay for this role is 60K-84. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits._
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
-
Claims Examiner Wc
5 months ago
Cape Town, South Africa Sedgwick Full timeTaking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for...
-
New England Claims Examiner
5 months ago
Cape Town, South Africa Sedgwick Full timeTaking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for...
-
Claims Advisor
5 months ago
Cape Town, South Africa Marsh Full time**Claims Advisor - Marsh - Brackenfell, Cape Town - Fixed Term Contract** **Please note this role will be based onsite at our clients’ offices - Shoprite Monday to Friday.** **The company: Marsh** Marsh is the world’s leading insurance broker and risk adviser. With over 35,000 colleagues operating in more than 130 countries, Marsh serves commercial...
-
Senior Claims Technician
6 months ago
Cape Town, South Africa Guardrisk Full time**Introduction** - Full support to Claims team, from loading of claims, appointment of surveyors, adjusting claims and preparing agreements of loss, estimate revision, drafting of repudiation letters, managing your own diary, appointment of recovery agents and supporting the Claims Manager with ad-hoc reporting and duties as assigned from time to time.**Role...
-
Claims Service Consultant
5 months ago
Cape Town, South Africa Sanlam Full time**Who are we?** Santam is the market leader in the general insurance industry in Southern Africa. We are a large, diversified, expanding and transforming company and whilst based in South Africa, we are rapidly moving into a number of emerging markets, both in Africa and Asia. Our success is rooted in our passion for our clients and everything we do is...
-
Senior Claims Verification Specialist
4 days ago
Cape Town, Western Cape, South Africa Road Accident Fund Full timeAbout the RoleWe are seeking an experienced Claims Validation and Assurance Expert to join our team at the Road Accident Fund.This is a 12-month fixed-term contract position that offers a Total Employment Cost package with no additional contributions from the employer.Job DescriptionThe successful candidate will be responsible for verifying and validating...
-
Forensic Planner
7 months ago
Cape Town, South Africa Kirby Group Engineering Full time**About Kirby Group Engineering** **Role Purpose** To work with internal Project Planning Teams to ensue project schedules, records and reports are setup and maintained in accordance with contractual requirements, internal best practices, enabling the preparation of prospective and retrospective delay and disruption analyses, providing effective delay and...
-
Chief Medical Officer
5 months ago
Cape Town, South Africa RGA Full time**Position Overview** Overview** This is a Permeant role with part time hours Serves as a medical consultant to the South African markets for traditional life underwriting, living benefits and claims. Evaluates medical tests/information, assesses risks, and research medical procedures and information. Provides ongoing education and training for...
-
Officer, Supply Chain Insurance
1 month ago
Cape Town, South Africa Standard Bank of South Africa Limited Full timeBusiness Segment: Insurance & Asset Management To perform service provider management services for the Supply Chain Management Function within Standard Insurance Limited in order to enhance the client service experience. Perform Supply Chain Management specialist services across the entire value chain for a specific regional portfolio to ensure optimal...
-
Merit Field Investigator
2 months ago
Cape Town, South Africa Sanlam Full time**CAREER OPPORTUNITY** - Santam’s Merit Claims department has a position available for a Motor Merit Field Assessor based in Cape Town, Western Cape.The Merit Field Assessor will ensure that all flagged and segmented claims are comprehensively validated to achieve conclusive results. The successful incumbent will maintain credibility by ensuring that all...
-
Merit Field Investigator
4 weeks ago
Cape Town, South Africa Sanlam Full timeCAREER OPPORTUNITY Santam’s Merit Claims department has a position available for a Motor Merit Field Assessor based in Cape Town, Western Cape. JOB DESCRIPTION The Merit Field Assessor will ensure that all flagged and segmented claims are comprehensively validated to achieve conclusive results. The successful incumbent will maintain credibility by ensuring...
-
Sales East Africa
6 months ago
Cape Town, South Africa AJC International Full time**About AJC International**: **Job Summary**: The purpose of this role is to generate profitable sales of frozen food commodities like poultry, pork, and beef for a given geographical region while meeting sales plan metrics. This is a customer facing role that entails maintaining and increasing current customer accounts and developing new customers. This...
-
Sales East Africa
5 months ago
Cape Town, South Africa AJC International Full time**About AJC International**: **Job Summary**: The purpose of this role is to generate profitable sales of frozen food commodities like poultry, pork, and beef for a given geographical region while meeting sales plan metrics. This is a customer facing role that entails maintaining and increasing current customer accounts and developing new customers. This...
-
Sales Manager
1 month ago
Cape Town, South Africa Michael Page Full timeAbout Our Client Our client is a a global leader in the procurement and sale of frozen meat, poultry, pork, seafood and vegetable products with an office in Cape Town, South Africa. Job Description The selected Sales Manager - East Africa will be responsibile for the following but not limited to: Sales Management (50%) · Maintain accounts by staying in...
-
Sales Manager
1 month ago
Cape Town, South Africa Michael Page Full timeAbout Our Client Our client is a a global leader in the procurement and sale of frozen meat, poultry, pork, seafood and vegetable products with an office in Cape Town, South Africa. Job Description The selected Sales Manager - West Africa will be responsibile for the following but not limited to: Sales Management (50%) · Maintain accounts by staying in...
-
Sales West Africa
6 months ago
Cape Town, South Africa AJC International Full time**About AJC International**: **Job Summary**: The purpose of this role is to generate profitable sales of frozen food commodities like poultry, pork, Seafood, French Fries, Vegetables, and beef for a given geographical region while meeting sales plan metrics. This is a customer facing role that entails maintaining and increasing current customer accounts and...
-
Sales West Africa
5 months ago
Cape Town, South Africa AJC International Full time**About AJC International**: **Job Summary**: The purpose of this role is to generate profitable sales of frozen food commodities like poultry, pork, Seafood, French Fries, Vegetables, and beef for a given geographical region while meeting sales plan metrics. This is a customer facing role that entails maintaining and increasing current customer accounts and...
-
Operations Manager
5 months ago
Cape Town, South Africa Job Crystal Full time_**Purpose of the Job**_ Manage the overall operations in the Personal and Commercial Underwriting and Claims Department by managing projects, preparing and generating reports, presenting recommendations for strategies, managing and guiding staff as well as presenting recommendations for strategies and analysing the operations of the department in order...
-
Consultant: Verification and Validation x2
5 days ago
Cape Town, South Africa Road Accident Fund Full timeNB: This is a 12 Month’s Fixed Term Contract Position Purpose of the Job: The Consultant: Verification and Validation is responsible for the verification and validation of registered claims Key Performance Areas Verification and Validation Apply sound legal (RAF Act and Regulations to Act, Case Law) knowledge on daily basis to validate claims....
-
Assistant Financial Controller
5 months ago
Cape Town, South Africa HotelJobs.co.za Full timeLarge Hotel in Cape Town is currently looking for an Assistant Financial Controller to ensure the smooth and efficient running of the Finance Division and Information Systems Departments. Responsible for: - Ensures that each section of the Accounting and Finance Department is managed efficiently, maximising utilisation of technology. - Ensures that the...