Claims Examiner - Workers Compensation | Jurisdiction: OR | Licensing: OR Cert preferred - Remote

Sedgwick Claims Management Services Ltd; United States; Hybrid; USD 64,000 - 85,000; Full time

Benefits offered by this job

Medical benefits

401k matching

PTO

Life insurance

Job summary

Sedgwick in the United States is seeking a Claims Examiner - Workers Compensation to analyze claims, determine benefits due, and adjudicate them in line with client requirements and industry best practices. Join a global leader offering flexible work options, comprehensive benefits, and a culture built on empathy, collaboration, and growth, while contributing to high-stakes claims for major brands.

Location flexibility includes remote/hybrid options; requires 5 years of claims experience and

Qualifications

• Education & Licensing: High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.
• Experience: 5 years of claims management experience or equivalent combination of education and experience required.
• Licensing / Jurisdiction Knowledge: OR

Responsibilities

• Analyze and processing claims through well-developed action plans to determine exposure on the claim.
• Negotiate settlement of claims within designated authority.
• Communicate claim activity and processing with the claimant and the client.
• Report claims to the excess carrier and respond to requests of directions in a professional and timely manner.

Skills

Claims management

Analytical ability

Negotiation

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 | Jurisdiction: WA & OR | Licensing: OR Cert 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? Apply your Claims Examiner, WC knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. 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.
• Licensing / Jurisdiction Knowledge: OR

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

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 ($64k-85k).

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.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance, the San Diego Fair Chance Ordinance, the San Francisco Fair Chance Ordinance, the California Fair Chance Act, and all other applicable laws. 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.

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.

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For more, see sedgwick.com