Remote Claims Examiner - Workers' Compensation

Sedgwick; Salem (OR); Remote; USD 75,000 - 90,000; Full time

Benefits offered by this job

Medical, dental, vision

401K with match

PTO

Flexible spending or HSA

Employee assistance

Life insurance

Job summary

Sedgwick is seeking a Claims Examiner - Workers Compensation with jurisdiction AK and remote work options. Primary duties include processing low-level WC claims, adjudicating benefits, and coordinating actions to resolution with supervision.

The role emphasizes subrogation, settlements, and maintaining thorough documentation. Ideal candidates bring 5 years of claims management experience, a HS diploma or GED (Bachelor's preferred), and relevant certifications.

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.
• Develops and coordinates action plans to resolution, return-to-work efforts, and approves claim payments.
• Approves and processes assigned claims, determines benefits due, and administers action plan.
• 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.

Education

High School Diploma or GED

Bachelor's degree preferred

Job description

Sedgwick is seeking a Claims Examiner - Workers Compensation with jurisdiction AK and remote work options. Primary duties include processing low-level WC claims, adjudicating benefits, and coordinating actions to resolution with supervision.

The role emphasizes subrogation, settlements, and maintaining thorough documentation. Ideal candidates bring 5 years of claims management experience, a HS diploma or GED (Bachelor's preferred), and relevant certifications.