Remote Claims Examiner - Workers' Compensation

Sedgwick; Lansing (MI); Remote; USD 63,000 - 89,000; Full time

Benefits offered by this job

Flexible schedule

Referral incentive program

Agile environment

Career development

Job summary

Sedgwick is seeking a Claims Examiner - Workers’ Compensation to adjudicate complex claims for clients in a remote/work-from-home setting. You’ll apply WC knowledge, analyze exposures, negotiate settlements within authority, and communicate with claimants and clients to drive timely resolutions.

The ideal candidate has a high school diploma or GED, with 5 years of claims management experience and state licensing in the Southeast.

Qualifications

• Experience analyzing workers' compensation claims and determining benefits due.
• Ability to adjudicate claims following client requirements and industry best practices.
• Strong communication with claimants and clients to keep claims moving toward resolution.

Responsibilities

• Analyze and process claims to determine exposure and benefits.
• Negotiate settlements within designated authority.
• Communicate claim activity to claimants and clients.
• Report claims to excess carriers and respond to directions promptly.

Skills

Claims handling

WC knowledge

Negotiation

Communication

Education

High School Diploma or GED

Bachelor's degree (preferred)

Job description

Sedgwick is seeking a Claims Examiner - Workers’ Compensation to adjudicate complex claims for clients in a remote/work-from-home setting. You’ll apply WC knowledge, analyze exposures, negotiate settlements within authority, and communicate with claimants and clients to drive timely resolutions.

The ideal candidate has a high school diploma or GED, with 5 years of claims management experience and state licensing in the Southeast.