Remote Claims Examiner, Workers' Comp – Flexible Schedule

Sedgwick; Portland (OR); Remote; USD 75,000 - 90,000; Full time

Benefits offered by this job

Flexible schedule

Referral program

Agile environment

Career development

Medical/dental/vision benefits

Job summary

Sedgwick is seeking a Claims Examiner for Workers' Compensation with AK jurisdiction and remote work options. You will process low level workers' compensation claims to determine benefits, monitor reserves, and coordinate action plans under supervision.

The role requires strong claims management experience, AK licensing, and relevant certifications. Sedgwick offers flexible schedules, comprehensive benefits from day one, and opportunities for growth within a collaborative environment.

Qualifications

• 5 years of claims management experience or equivalent.
• 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 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 including state and physician filings and decisions on treatments.
• Maintains professional client relationships.

Skills

Claims management

Attention to detail

Education

High School Diploma or GED

Bachelor's degree preferred

Professional certification

Job description

Sedgwick is seeking a Claims Examiner for Workers' Compensation with AK jurisdiction and remote work options. You will process low level workers' compensation claims to determine benefits, monitor reserves, and coordinate action plans under supervision.

The role requires strong claims management experience, AK licensing, and relevant certifications. Sedgwick offers flexible schedules, comprehensive benefits from day one, and opportunities for growth within a collaborative environment.