Remote Workers' Comp Claims Adjuster

Sedgwick; Boise (ID); Remote; USD 60,000 - 75,000; Full time

Benefits offered by this job

Flexible schedule

Referral program

Agile environment

Career growth

Benefits package

Job summary

Sedgwick is seeking a remote Claims Adjuster for Workers' Compensation, handling adjudication and settlement activities across MI, TX, IN, IL, OH. The role supports complex claims with a focus on timely resolution and client satisfaction.

Qualified candidates have four years of claims management experience, a Bachelor's degree (preferred), and licensing requirements met in the home state. Sedgwick offers a comprehensive benefits package and career growth opportunities.

Qualifications

• Bachelor's degree preferred; professional certification as applicable to line of business preferred.

Responsibilities

• Manages workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.
• Develops and manages workers compensation claims’ action plans to resolution, coordinates return-to-work efforts, and approves claim payments.
• Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.
• Manages 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 complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
• Maintains professional client relationships.

Skills

Claims adjudication

Workers' compensation

Remote work

Education

Bachelor's degree preferred

Professional certification preferred

Job description

Sedgwick is seeking a remote Claims Adjuster for Workers' Compensation, handling adjudication and settlement activities across MI, TX, IN, IL, OH. The role supports complex claims with a focus on timely resolution and client satisfaction.

Qualified candidates have four years of claims management experience, a Bachelor's degree (preferred), and licensing requirements met in the home state. Sedgwick offers a comprehensive benefits package and career growth opportunities.