Remote Claims Examiner – Workers’ Compensation

Sedgwick; Little Rock (AR); Remote; USD 75,000 - 90,000; Full time

Benefits offered by this job

Flexible schedule

Referral program

Agile environment

Career growth

Benefits package

Job summary

Sedgwick is seeking a Claims Examiner - Workers' Compensation for the Alaska jurisdiction with remote options. The role processes low-level claims, determines benefits due, and supports subrogation and settlements under supervision.

Ideal candidates are driven, with the ability to follow company standards and industry best practices. A stable office environment is offered with flexible schedule and benefits; AK licensing is required for the jurisdiction noted.

Qualifications

• Education & Licensing: 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.

Job description

Sedgwick is seeking a Claims Examiner - Workers' Compensation for the Alaska jurisdiction with remote options. The role processes low-level claims, determines benefits due, and supports subrogation and settlements under supervision.

Ideal candidates are driven, with the ability to follow company standards and industry best practices. A stable office environment is offered with flexible schedule and benefits; AK licensing is required for the jurisdiction noted.