- Manage end-to-end WC claims —investigate, determine compensability, coordinate care, and work with stakeholders to deliver fair, timely resolutions
- This position will be staffed following the hybrid work model out of our Richmond, VA office
- Provide all aspects of customer service with empathy and understanding by assisting customers through difficult situations
- You are the primary point of contact between the injured employee, health care providers, and employers
- You’ll maintain active communication with all parties involved to gather information and provide updates on the status of claims
- Verify coverage, compensability and investigate causation by gathering pertinent information
- Conduct thorough investigations into the circumstances surrounding the injury or illness
- This may involve reviewing medical records, interviewing involved parties, and examining workplace conditions including job descriptions
- Assess the extent of the employee’s injury or illness to determine the benefits they are entitled to receive under WC laws
- This may include medical treatment and disability payments
- Actively manage and develop action plans to move files toward resolution
- Evaluate and approve payments to medical providers, suppliers, and the injured employee
- Accurately document all aspects of the claim, including investigation details, injury reports, medical records, and correspondence with any involved parties
- Ensure compliance with regulations governing WC claims, including reporting requirements, deadlines, and file coding as defined by the state
- Collaborate with special investigations unit (SIU) to assist in mitigating fraud and the subrogation team as necessary to assist with recovery efforts
As a Sentry associate, you will have an in-office workspace and materials for your home office
