Claims Examiner - Workers Compensation | Jurisdiction: Midwest States | Licensing: MI or MN Required

Sedgwick; Lansing (MI); Remote; USD 65,000 - 85,000; Full time

Benefits offered by this job

Flexible schedule

Referral incentives

Agile environment

Career development

Benefits package

Job summary

Sedgwick is seeking a Claims Examiner - Workers' Compensation to analyze claims for clients across the Midwest. You will determine benefits due and adjudicate within service expectations, collaborating with claimants and clients to reach timely resolutions.

The ideal candidate has a background in claims management, strong analytical and negotiation skills, and ability to operate in a flexible, office-based or remote environment within the Midwest footprint.

Qualifications

• High School Diploma or GED required; Bachelor's degree preferred.
• 5 years of claims management experience or equivalent.
• MI or MN licensing required.

Responsibilities

• Analyze and process workers' compensation claims to determine exposure and benefits.
• Negotiate settlements within designated authority.
• Communicate claim activity with claimants and clients.
• Report claims to excess carriers and provide directions as needed.

Skills

Claims analysis

Negotiation

Communication

Education

High School Diploma or GED

Bachelor's degree

Job description

Downers Grove, IL - Lacey

Negaunee, MI

US Telecommuter

Telecommuter IL

Full time

R79096

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 | Jurisdiction: Midwest States | Licensing: MI or MN Required

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 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 .

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

• 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.

Jurisdiction Knowledge: Midwest states

Licensing: MI or MN 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

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 ($65,000-$85,000 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