Remote Claims Examiner - Workers' Compensation

Sedgwick; Miami (FL); Remote; USD 65,000 - 81,000; Full time

Benefits offered by this job

Flexible schedule

Referral program

Agile environment

Career development

Benefits package

Job summary

Sedgwick, a global leader in risk and claims administration, seeks a Claims Examiner - Workers Compensation to analyze claims for our clients, determine benefits due, and adjudicate within service expectations and client requirements. This remote role covers Southeast jurisdictions.

Ideal candidates have 5 years of claims management experience, a high school diploma or GED (Bachelor's preferred), and FL or home-state licensing.

Qualifications

• Education & Licensing: 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.
• Experience: 5 years of claims management experience or equivalent combination of education and experience required.
• Licensing : FL or home state required
• Jurisdiction Knowledge: FL, GA, NC, SC, AL, AR, KY

Responsibilities

• Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
• Negotiating settlement of claims within designated authority.
• Communicating claim activity and processing with the claimant and the client.
• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

Skills

Claims management

Negotiation

Communication

Jurisdiction knowledge

Education

High School Diploma or GED

Bachelor's degree

Professional certification

Job description

Sedgwick, a global leader in risk and claims administration, seeks a Claims Examiner - Workers Compensation to analyze claims for our clients, determine benefits due, and adjudicate within service expectations and client requirements. This remote role covers Southeast jurisdictions.

Ideal candidates have 5 years of claims management experience, a high school diploma or GED (Bachelor's preferred), and FL or home-state licensing.