Claims Examiner - Workers Compensation | Jurisdiction & Licensing: AK - Required

Sedgwick; Concord (NH); Remote; USD 75,000 - 90,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development opportunities

Comprehensive benefits

Job summary

Sedgwick is seeking a detail‑oriented professional to process low level workers' compensation claims and determine benefits due under supervision. You will help adjudicate claims, monitor reserves, and coordinate subrogation and settlements while maintaining strong client communication.

This entry‑level to mid‑level role emphasizes accuracy, documentation, and adherence to guidelines within a collaborative, agile environment. A supportive benefits package and growth opportunities are offered.

Qualifications

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

Responsibilities

• Processes low level workers compensation claims determining compensability and benefits due on long term indemnity claims.
• Develops and coordinates action plans to resolution and return-to-work efforts.
• Approves and processes assigned claims and administers action plans per contract.
• Administers subrogation of claims and negotiates settlements.
• Communicates claim actions with claimants and clients.
• Ensures claim files are properly documented and coded.

Skills

Claims management

Attention to detail

Education

High School Diploma or GED

Bachelor's degree preferred

Professional certification preferred

Job description

Anchorage, AK

Telecommuter WA

Telecommuter OR

Telecommuter CO

US Telecommuter

Telecommuter AK

Telecommuter AZ

Full time

R77710

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

Job Description

Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career?

• A stable and consistent work environment in an office setting

PRIMARY PURPOSE OF THE ROLE:

To process low level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements with general supervision.

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.

ESSENTIAL RESPONSIBLITIES MAY INCLUDE

• Processes low level workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.

• Develops and coordinates low level workers compensation claims' action plans to resolution, return-to-work efforts, and approves claim payments.

• Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract.

• Administers subrogation of claims and negotiates settlements.

• Communicates claim action with claimant and client.

• Ensures claim files are properly documented and claims coding is correct.

• May process low-level lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.

• Maintains professional client relationships.

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.

Jurisdiction Knowledge:

AK

Licensing:

AK

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

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.

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 (75,000-90,000 USD Annual). 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.

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.

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