Remote Claims Examiner – Workers’ Comp (AK)

Sedgwick; Madison (WI); Remote; USD 75,000 - 90,000; Full time

Benefits offered by this job

Flexible schedule

Referral incentives

Agile environment

Career development opportunities

Day-one benefits

Job summary

Sedgwick is seeking a Claims Examiner for Workers' Compensation in AK with remote work options. You will process low-level claims, determine benefits, and coordinate actions under supervision to ensure timely adjudication.

Ideal candidates have 5 years of claims experience, AK knowledge, and a commitment to client service. Sedgwick offers growth, a caring culture, and supportive benefits as part of a dynamic team.

Qualifications

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

Responsibilities

• Processes low level workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.
• Develops and coordinates low level workers compensation claims' action plans to resolution, return-to-work efforts, and approves claim payments.
• Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract.
• Administers subrogation of claims and negotiates settlements.
• Communicates claim action with claimant and client.
• Ensures claim files are properly documented and claims coding is correct.
• May process low-level lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
• Maintains professional client relationships.

Skills

claims management

AK jurisdiction knowledge

Education

High School Diploma or GED

Bachelor's degree preferred

Professional certification preferred

Job description

Sedgwick is seeking a Claims Examiner for Workers' Compensation in AK with remote work options. You will process low-level claims, determine benefits, and coordinate actions under supervision to ensure timely adjudication.

Ideal candidates have 5 years of claims experience, AK knowledge, and a commitment to client service. Sedgwick offers growth, a caring culture, and supportive benefits as part of a dynamic team.