Claims Examiner I Workers Compensation (REMOTE) I FL, GA, NC or SC experience

Sedgwick Claims Management Services Ltd; United States; Remote; USD 60,000 - 85,000; Full time

Benefits offered by this job

Medical insurance

401k and matching

PTO and disability insurance

Job summary

Sedgwick is hiring for a claims examiner to analyze workers' compensation claims on behalf of clients, determine benefits, and adjudicate within service expectations.

The role requires experience in claims management, knowledge of relevant jurisdictions (FL, GA, NC, SC), and a commitment to accuracy and timely processing. A comprehensive benefits package is provided and remote work is available in designated states.

Qualifications

• 5 years of claims management experience or equivalent combination of education and experience.
• Licensing/Jurisdiction knowledge in FL, GA, NC, SC.
• Bachelor's degree preferred; professional certification as applicable to line of business is a plus.

Responsibilities

• Analyzing and processing claims through action plans to a timely resolution by investigating information to determine exposure.
• Negotiating settlement of claims within designated authority.
• Communicating claim activity with the claimant and the client.
• Reporting claims to the excess carrier and responding to directions in a professional and timely manner.

Skills

Claims management experience

Education

High School Diploma or GED

Bachelor's degree

Job description

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 Examiner I Workers Compensation (REMOTE) I FL, GA, NC or SC experience

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 RESPONSIBILITIES 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: 5 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: FL, GA, NC, SC

Work environment requirements include – Physical: Computer keyboarding Auditory/visual: Hearing, vision and talking Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.

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 $60,234 - $85,000/yr.

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.

We offer a diverse and comprehensive benefits offering including medical, dental vision, 401K on day one. Referral incentive program. Opportunity to work in an agile environment. Career development and promotional growth opportunities.

Equal Opportunity Employer and a Drug-Free Workplace. Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company’s expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see sedgwick.com