Remote Workers' Comp Claims Adjuster

Sedgwick; Dallas (TX); Remote; USD 60,000 - 75,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Agile environment

Career development and promotional增长

Medical, dental, vision, 401K on day 1

Job summary

Sedgwick is hiring a remote Claims Adjuster for Workers' Compensation with jurisdiction coverage including MI, TX, IN, IL, OH. The role requires a bachelor’s degree and four years of claims experience, plus licensing in the home state.

You will adjudicate complex claims, manage subrogation, and coordinate with clients to ensure proper documentation and timely settlements. The position offers flexible work arrangements, a supportive culture, and comprehensive benefits.

Qualifications

• Bachelor's degree from an accredited college or university preferred.
• Professional certification as applicable to line of business preferred.
• Four (4) years of claims management experience or equivalent combination of education and experience required.
• Jurisdiction knowledge MI, TX, IN, IL, OH.
• Licensing: Home State Required.

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 management

Analytical thinking

Communication skills

Education

Bachelor's degree

Job description

Sedgwick is hiring a remote Claims Adjuster for Workers' Compensation with jurisdiction coverage including MI, TX, IN, IL, OH. The role requires a bachelor’s degree and four years of claims experience, plus licensing in the home state.

You will adjudicate complex claims, manage subrogation, and coordinate with clients to ensure proper documentation and timely settlements. The position offers flexible work arrangements, a supportive culture, and comprehensive benefits.