Remote Insurance Utilization Review Jobs in Louisiana

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.

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Are you lookingfor 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.

ARE YOU AN IDEAL CANDIDATE? We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

WORK LOCATIONS: Hybrid work schedule if within 25 miles of the Baton Rouge, LA office, if outside of this radius remote work location will be explored.

PRIMARY PURPOSE OF THE ROLE:To process low level general liability claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements with general supervision.

ESSENTIAL RESPONSIBLITIES MAY INCLUDE

• Processes low level general liability claims by gathering information to determine liability exposure; assigns reserve values to claims, making claims payments as necessary, and settling claims up to designated authority level.

• Develops and coordinates low level general liability claims' action plans to resolution, return-to-work efforts, and approves claim payments.

• Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract.

• Administers subrogation of claims and negotiates settlements.

• Communicates claim action with claimant and client.

• Ensures claim files are properly documented and claims coding is correct.

• May process low-level lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.

• Maintains professional client relationships.

• Performs other duties as assigned, Supports the organization's quality program(s), Travels as required.

QUALIFICATIONS

Education & Licensing: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.

Experience:2years of claims management experience or equivalent combination of education and experience required.

Licensing / Jurisdiction Knowledge:LA

TAKING CARE OF YOU

• Flexible work schedule.

• Referral incentive program.

• Career development and promotional growth opportunities.

• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

WORK ENVIRONMENT REQUIREMENTSINCLUDE
When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental:Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical:Computer keyboarding,travel as required

Auditory/Visual: Hearing, vision and talking

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description.They are not intended to constitute a comprehensive list of functions, duties, or local variances.Management retains the discretion to add or to change the duties of the position at any time.

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Sedgwickis an Equal Opportunity Employer and a Drug-Free Workplace.