Claims Examiner - Workers Compensation

Sedgwick; Oregon; Hybrid; USD 65,000 - 90,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Agile environment

Career development

Medical, dental, vision, 401K on day 1

Job summary

Sedgwick is seeking a Claims Examiner - Workers' Compensation in Oregon to analyze and adjudicate claims for benefits, ensuring service expectations and client requirements are met.

Ideal candidates have 5+ years of claims management experience, a high school diploma or GED (Bachelor's preferred), and strong negotiation and communication skills. Sedgwick offers flexible schedules, development opportunities, and comprehensive benefits.

Qualifications

• High School Diploma or GED required.
• Bachelor's degree preferred.
• Professional certification as applicable to line of business preferred.
• 5 years of claims management experience or equivalent combination.

Responsibilities

• Analyzing and processing claims through action plans to resolution by gathering information.
• Negotiating settlement of claims within designated authority.
• Communicating claim activity with the claimant and client.
• Reporting claims to the excess carrier and responding to directions.

Skills

Claims analysis

Negotiation

Client communication

Decision making

Education

High School Diploma or GED

Bachelor's degree preferred

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 - Workers Compensation

Are you looking for 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.
• Leverage Sedgwick's broad, global network of experts to both learn from and to share your insights.
• Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.
• Enjoy flexibility and autonomy in your daily work, your location, and your career path.
• Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

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.

PRIMARY PURPOSE OF THE ROLE

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 RESPONSIBLITIES 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: 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: 5 years of claims management experience or equivalent combination of education and experience required.

TAKING CARE OF YOU

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

WORK ENVIRONMENT REQUIREMENTS INCLUDE

• 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.

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