Hybrid Workers' Compensation Claims Examiner — Growth & Impact

Sedgwick; Omaha (NE); Hybrid; USD 60,000 - 84,000; Full time

Benefits offered by this job

Flexible schedule

Referral program

Agile environment

Career development

Comprehensive benefits

Job summary

Sedgwick seeks a dedicated Workers’ Compensation Claims Examiner to analyze complex claims for our clients. The role supports adjudication in line with service expectations and client requirements.

Hybrid work with two days in the office; office locations include Omaha, NE or West Des Moines, IA. Ideal candidates have 5+ years of claims experience and strong negotiation and analytical skills.

Qualifications

• Five (5) years of claims management experience or equivalent combination of education and experience.
• Bachelor’s degree from an accredited college or university preferred.
• Professional certification as applicable to line of business preferred.

Responsibilities

• Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine exposure.
• Negotiates settlement of claims within designated authority.
• Calculates and assigns reserves to claims and manages reserve adequacy.
• Calculates and pays benefits due and settles claims within authority.
• Prepares necessary state filings within statutory limits.
• Manages the litigation process and coordinates vendor referrals for investigation or litigation management.
• Uses cost containment techniques including vendor partnerships to reduce overall costs for clients.

Skills

Claims management

Negotiation

Analytical skills

Communication

Microsoft Office

Teamwork

Cost containment

Education

Bachelor’s degree

Professional certification (preferred)

Tools

Microsoft Office

Job description

Sedgwick seeks a dedicated Workers’ Compensation Claims Examiner to analyze complex claims for our clients. The role supports adjudication in line with service expectations and client requirements.

Hybrid work with two days in the office; office locations include Omaha, NE or West Des Moines, IA. Ideal candidates have 5+ years of claims experience and strong negotiation and analytical skills.