Remote Claims Examiner, Workers’ Compensation

Sedgwick; Salem (OR); Remote; USD 60,000 - 90,000; Full time

Benefits offered by this job

Flexible schedule

Referral program

Agile environment

Career development

Benefits package

Job summary

Sedgwick is seeking a driven Claims Examiner to analyze workers’ compensation claims and determine benefits due for clients across industries. You will adjudicate complex claims with a focus on timely, accurate resolutions while upholding service standards.

The ideal candidate has 5 years of claims management experience, a high school diploma or GED, and relevant certifications. The role offers flexible work arrangements and a comprehensive benefits package.

Qualifications

• 5 years of claims management experience or equivalent
• High School Diploma or GED required; Bachelor's degree preferred
• Professional certification as applicable to line of business preferred
• Licensing/Jurisdiction knowledge across NH, VT, MA, CT, RI, DC, DE, WV, VA

Responsibilities

• Analyzing and processing claims through well-developed action plans to determine exposure and resolve the claim timely
• Negotiating settlements within designated authority
• Communicating claim activity with the claimant and client
• Reporting claims to excess carriers and responding to directions professionally and timely

Skills

Claims analysis

Negotiation

Communication

Adjudication

Education

High School Diploma or GED

Bachelor's degree preferred

Professional certification where applicable

Job description

Sedgwick is seeking a driven Claims Examiner to analyze workers’ compensation claims and determine benefits due for clients across industries. You will adjudicate complex claims with a focus on timely, accurate resolutions while upholding service standards.

The ideal candidate has 5 years of claims management experience, a high school diploma or GED, and relevant certifications. The role offers flexible work arrangements and a comprehensive benefits package.