Remote Claims Examiner – Workers' Compensation

Sedgwick; Jackson (MS); Remote; USD 75,000 - 90,000; Full time

Benefits offered by this job

Flexible schedule

Referral incentives

Agile environment

Career development

Medical/Dental/Vision + 401K

Job summary

Sedgwick is seeking a Claims Examiner for Workers' Compensation in Alaska. This remote role processes low level claims, determines benefits, and coordinates action plans to resolution with supervision. The position emphasizes accurate documentation, subrogation, and client communication.

Ideal candidates have a background in claims management, a high school diploma or GED, and strong organizational skills. Sedgwick offers a robust benefits package and opportunities for career growth in a

Qualifications

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

Detail oriented

Communication

Education

High School Diploma or GED

Bachelor's degree preferred

Job description

Sedgwick is seeking a Claims Examiner for Workers' Compensation in Alaska. This remote role processes low level claims, determines benefits, and coordinates action plans to resolution with supervision. The position emphasizes accurate documentation, subrogation, and client communication.

Ideal candidates have a background in claims management, a high school diploma or GED, and strong organizational skills. Sedgwick offers a robust benefits package and opportunities for career growth in a