Remote WC Claims Examiner - Investigate & Resolve

Sedgwick Claims Management Services Ltd; United States; Hybrid; USD 64,000 - 85,000; Full time

Benefits offered by this job

Medical benefits

401k matching

PTO

Life insurance

Job summary

Sedgwick in the United States is seeking a Claims Examiner - Workers Compensation to analyze claims, determine benefits due, and adjudicate them in line with client requirements and industry best practices. Join a global leader offering flexible work options, comprehensive benefits, and a culture built on empathy, collaboration, and growth, while contributing to high-stakes claims for major brands.

Location flexibility includes remote/hybrid options; requires 5 years of claims experience and

Qualifications

• Education & Licensing: High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.
• Experience: 5 years of claims management experience or equivalent combination of education and experience required.
• Licensing / Jurisdiction Knowledge: OR

Responsibilities

• Analyze and processing claims through well-developed action plans to determine exposure on the claim.
• Negotiate settlement of claims within designated authority.
• Communicate claim activity and processing with the claimant and the client.
• Report claims to the excess carrier and respond to requests of directions in a professional and timely manner.

Skills

Claims management

Analytical ability

Negotiation

Education

High School Diploma or GED

Bachelor's degree preferred

Job description

Sedgwick in the United States is seeking a Claims Examiner - Workers Compensation to analyze claims, determine benefits due, and adjudicate them in line with client requirements and industry best practices. Join a global leader offering flexible work options, comprehensive benefits, and a culture built on empathy, collaboration, and growth, while contributing to high-stakes claims for major brands.

Location flexibility includes remote/hybrid options; requires 5 years of claims experience and