Claims Examiner - Workers Compensation | Jurisdiction: Multi State | Licensing:

Visa Hunt; United States; On-site; USD 60,000 - 85,000; Full time

Benefits offered by this job

Flexible work arrangement

Referral incentive program

Agile environment

Career development opportunities

Comprehensive benefits (medical,Dental

Job summary

Sedgwick is seeking a Claims Examiner to analyze complex workers' compensation claims, including high exposure matters with litigation and rehabilitation. The role emphasizes adjudication quality, client service, and potential subrogation opportunities.

The ideal candidate has 5+ years in claims management, a multi-state license or willingness to obtain one (TX/FL or home state preferred), and may work remotely with flexible scheduling. Sedgwick offers strong benefits and career growth.

Qualifications

• Education: High School Diploma or GED required; Bachelor's degree preferred.
• Professional certification relevant to line of business preferred.
• Experience: 5 years of claims management experience or equivalent.
• Licensing: Multi-state, TX/FL or Home State preferred; remote work allowed.

Responsibilities

• Analyze complex or technically difficult workers' compensation claims to determine benefits due;
• work with high exposure claims involving litigation and rehabilitation;
• ensure ongoing adjudication of claims within service expectations and client requirements;
• identify subrogation and negotiate settlements.
• Communicate claim activity with claimants and clients.

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 - Workers Compensation | Jurisdiction: Multi State | Licensing: TX/FL or Home State preferred (Remote)

• 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 ROLETo analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.

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

Licensing / Jurisdiction Knowledge: Multi state, TX/FL or Home State preferred

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 REQUIREMENTSINCLUDEWhen 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

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