Hybrid Workers’ Comp Claims Specialist I

Sedgwick; Montgomery (AL); Hybrid; USD 47,011 - 70,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401(k) with matching

Paid time off

Disability insurance

Life insurance

Employee assistance program

HSA/Flex spending

Job summary

Sedgwick is looking for a Claims Adjuster I – Workers Compensation (CA) in a hybrid work setting. You will analyze mid- to high-level workers' compensation claims to determine benefits, manage reserves, and coordinate subrogation and settlements with clients.

The role requires strong communication and analytical skills, MS Office proficiency, and adherence to regulations and company standards. A bachelor’s degree is preferred, along with four years of claims experience and the ability to support

Qualifications

• Bachelor's degree preferred.
• Four years of claims management experience or equivalent.
• Working knowledge of regulations, offsets and deductions, disability duration, medical management practices, and Social Security/Medicare procedures.

Responsibilities

• Analyzes mid- and higher-level workers' compensation claims to determine benefits due and ensure adjudication within standards.
• Develops and manages action plans, coordinates return-to-work, and approves claim payments.
• Manages subrogation and negotiates settlements with claimants and clients.
• Communicates claim action with claimants and clients and maintains proper documentation.

Skills

Regulations knowledge

Disability duration

Medical management

Social Security/Medicare process

Communication skills

MS Office

Analytical skills

Teamwork

Negotiation skills

Education

Bachelor's degree

Tools

Microsoft Office

Job description

Sedgwick is looking for a Claims Adjuster I – Workers Compensation (CA) in a hybrid work setting. You will analyze mid- to high-level workers' compensation claims to determine benefits, manage reserves, and coordinate subrogation and settlements with clients.

The role requires strong communication and analytical skills, MS Office proficiency, and adherence to regulations and company standards. A bachelor’s degree is preferred, along with four years of claims experience and the ability to support