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

Sedgwick; Dallas (TX); Hybrid; USD 60,000 - 80,000; Full time

Benefits offered by this job

Flexible schedule

Referral incentive

Agile environment

Career growth

Benefits package

Job summary

Sedgwick is seeking a Claims Examiner - Workers' Compensation to analyze complex or high-exposure workers’ compensation claims, determine benefits, and adjudicate within client requirements. This role includes negotiating settlements, coordinating with claimants and clients, and supporting subrogation efforts.

The ideal candidate has at least 5 years of claims management experience, a high school diploma or GED (Bachelor's preferred), and multi-state licensing knowledge (TX/FL or home state

Qualifications

• Education & licensing: High School Diploma or GED required; Bachelor's degree preferred.
• Experience: 5 years of claims management experience or equivalent.
• Licensing/Jurisdiction: Multi-state knowledge; TX/FL or Home State preferred.

Responsibilities

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

Skills

Claims management

Negotiation

Client communication

Education

High School Diploma or GED

Bachelor's degree preferred

Professional certification

Job description

Telecommuter MI

Telecommuter FL

Telecommuter TX

Full time

R77650

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)

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?

• 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 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: 5 years 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 REQUIREMENTS INCLUDE

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

#claimsexaminer #claims #hybrid #LI-REMOTE

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

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