Claims Adjuster - Workers Compensation - Telecommute OR

Sedgwick; Oregon (IL); Remote; USD 51,000 - 84,000; Full time

Job summary

A leading company seeks a Claims Adjuster for Workers Compensation in a telecommute role, offering flexibility and a supportive work environment. As part of the team, you will manage lower-level claims, ensuring proper adjudication and compliance with industry standards. This entry-level position requires strong communication and analytical skills, along with a high school diploma. Competitive salary and benefits are included.

Qualifications

• 1+ year general office experience or equivalent required.
• Claims industry experience preferred.
• Licenses as required.

Responsibilities

• Analyze reported lower-level workers compensation claims.
• Process claims determining compensability and benefits due.
• Adjust medical-only claims and minor lost-time claims.

Skills

Excellent oral and written communication skills

Analytical and interpretive skills

Strong organizational skills

Good interpersonal skills

Ability to work in a team environment

Education

High school diploma or GED

Tools

Microsoft Office

Job description

Join to apply for the Claims Adjuster - Workers Compensation - Telecommute OR role at Sedgwick

3 days ago Be among the first 25 applicants

Join to apply for the Claims Adjuster - Workers Compensation - Telecommute OR role at Sedgwick

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.

Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies

Certified as a Great Place to Work

Fortune Best Workplaces in Financial Services & Insurance

Claims Adjuster - Workers Compensation - Telecommute OR

PRIMARY PURPOSE: To analyze reported lower-level 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).
  
  

QUALIFICATION

Education & Licensing

High school diploma or GED required. Licenses as required.

Experience

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

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
  
  

WORK ENVIRONMENT

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.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Finance and Sales

• Industries

  Insurance

Referrals increase your chances of interviewing at Sedgwick by 2x

Get notified about new Claims Adjuster jobs in Oregon, United States.

Portland, OR $51,807.00-$83,551.00 3 days ago

Medical Claims Analyst - Claims Processor REMOTE

Oregon, United States $18.00-$26.00 3 months ago

Sr. Adjuster - Multiline (Remote in Portland, OR)

Oregon, United States $85,000.00-$90,000.00 4 months ago

Oregon, United States $65,000.00-$79,400.00 3 days ago

Claims Reviewer- Priority Claims (Telecommuting Opportunity)

Dental PR Claims Entry Operator - Temporary

Sr. Professional Liability Medical Claims Manager *Remote*

Portland, OR $175,000.00-$225,000.00 2 weeks ago

Portland, OR $77,235.00-$115,852.00 6 days ago

We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.