Workers Compensation Consultant- Level 1

Sedgwick; Kawartha Lakes; On-site; CAD 100,000 - 125,000; Full time

Job summary

A leading claims management firm is seeking a Workers Compensation Consultant to analyze workers compensation claims and support representatives in managing claims processes. The ideal candidate will have a high school diploma and at least one year of experience in a general office environment, with preferred experience in the claims industry. Strong communication, analytical, and organizational skills are essential. This role offers opportunities to work within a collaborative team environment in Kawartha Lakes, Ontario.

Qualifications

• 1 year of general office experience or equivalent combination of education and experience.
• Experience in claims industry preferred.

Responsibilities

• Analyze less complex workers compensation claims to determine benefits due.
• Process claims determining compensability and benefits due.
• Communicate claims action to claimants, clients, and medical contacts.

Skills

Communication skills

PC literacy

Analytical skills

Organizational skills

Interpersonal skills

Teamwork

Education

High school diploma

Tools

Microsoft Office

Job description

Workers Compensation Consultant - Level 1

We’re hiring Workers’ Compensation Consultants! If you have experience handling Workers Compensation claims across Canadian jurisdictions—or background in absence management, leave administration, STD/LTD adjudication—we’d love to have you on our team.

• Paralegal expertise for handling claims, appeals, and compliance matters
• Strong knowledge of workers’ compensation legislation and health & safety standards
• Proven ability to manage complex claims processes and collaborate with stakeholders
• Experience in HR leave programs, disability case management, and policy interpretation

If you are passionate about supporting colleagues through challenging times and ensuring compliance, we want to hear from you!

PRIMARY PURPOSE

To analyze reported less complex workers compensation claims to determine benefits due; and to ensure ongoing adjudication of claims within company standards and industry best practices.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Adjusts medical‑only claims and minor lost‑time workers compensation claims under close supervision.
• Supports other claims representatives, examiners and leads with larger or more complex claims as necessary.
• Processes workers compensation claims determining compensability and benefits due; monitors reserve accuracy, and files necessary documentation with state agency.
• Communicates claim action/processing with claimant, client and appropriate medical contact.
• Ensures claim files are properly documented and claims coding is correct.
• May process routine payments and prescriptions and status reports for lifetime medical claims and/or defined period medical claims.
• Maintains professional client relationships.

ADDITIONAL FUNCTIONS AND RESPONSIBILITIES

• Performs other duties as assigned.
• Supports the organization’s quality program(s).

QUALIFICATIONS

Education & Licensing

• High school diploma required.

Experience

• One (1) year of general office experience or equivalent combination of education and experience required. Claims industry experience preferred.
• Skills & Knowledge

Skills & Knowledge

• Excellent oral and written communication skills
• PC literate, including Microsoft Office products
• Analytical and interpretive skills
• Strong organizational skills
• Good interpersonal skills
• Ability to work in a team environment
• Ability to meet or exceed Performance Competencies

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.

Where applicable, Sedgwick uses artificial intelligence tools to assist in the screening, assessment, or selection of candidates. These tools are subject to periodic review.

We are committed to inclusive, barrier‑free recruitment and selection processes. If contacted for an employment opportunity, please advise Colleague Resources if you require accommodation.

Sedgwick is an Equal Opportunity Employer.