Remote Claims Examiner - Workers' Compensation

Sedgwick; Carson City (NV); Remote; USD 75,000 - 90,000; Full time

Benefits offered by this job

Medical, dental, vision

401K on day one

PTO

Job summary

Sedgwick is seeking a Claims Examiner for Workers’ Compensation with AK jurisdiction and remote work options. No prior experience required, offering a meaningful, career-building role in a caring culture and strong work-life balance.

You will process low-level workers' compensation claims, determine benefits, and coordinate action plans toward resolution under supervision, including subrogation and settlements where applicable. Flexible schedule and comprehensive benefits are provided.

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.

Education

High School Diploma or GED

Bachelor's degree from an accredited college or university preferred

Job description

Sedgwick is seeking a Claims Examiner for Workers’ Compensation with AK jurisdiction and remote work options. No prior experience required, offering a meaningful, career-building role in a caring culture and strong work-life balance.

You will process low-level workers' compensation claims, determine benefits, and coordinate action plans toward resolution under supervision, including subrogation and settlements where applicable. Flexible schedule and comprehensive benefits are provided.