Remote Claims Examiner, Workers’ Compensation | Flexible Hybrid

Sedgwick; Boise (ID); Hybrid; USD 70,000 - 85,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Agile environment

Career development opportunities

Comprehensive benefits

Job summary

Sedgwick is seeking a Claims Examiner - Workers’ Compensation to analyze complex workers’ compensation claims for clients, determine benefits due, and support adjudication within service expectations.

We offer flexible work arrangements, an agile environment, and a comprehensive benefits package including medical, dental, vision, 401K, and more. MD/NJ jurisdiction knowledge is preferred.

Qualifications

• High School Diploma or GED required; bachelor’s degree preferred.
• 5 years of claims management experience or equivalent.
• Licensing: Home state preferred; jurisdiction knowledge MD & NJ.

Responsibilities

• Analyzing and processing workers' compensation claims to determine benefits due, with adjudication aligned to client service requirements.
• Negotiating settlements within designated authority.
• Communicating claim activity and processing with the claimant and the client.
• Reporting claims to the excess carrier and responding to directions in a professional and timely manner.

Skills

WC claims knowledge

Claims adjudication

Education

High School Diploma or GED

Bachelor's degree preferred

Professional certification

Job description

Sedgwick is seeking a Claims Examiner - Workers’ Compensation to analyze complex workers’ compensation claims for clients, determine benefits due, and support adjudication within service expectations.

We offer flexible work arrangements, an agile environment, and a comprehensive benefits package including medical, dental, vision, 401K, and more. MD/NJ jurisdiction knowledge is preferred.