Remote Workers' Comp Claims Adjuster

Sedgwick; Mobile (AL); Remote; USD 60,000 - 75,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentives

Career development opportunities

Job summary

Sedgwick is seeking a Claims Adjuster for Workers’ Compensation with jurisdiction coverage in MI, TX, IN, IL, and OH. Remote, full-time role requiring licensing and home-state compliance.

You will adjudicate complex claims, determine benefits, and negotiate settlements for a global leader in risk and claims management. Ideal candidates have 4+ years in claims management, a Bachelor's degree, and familiarity with workers’ compensation regulations.

Qualifications

• Bachelor's degree from an accredited college or university 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

• Analyzes mid- and higher-level workers compensation claims to determine benefits due and adjudicate within standards.
• Develops and manages claims action plans toward resolution and coordinates return-to-work efforts; approves payments.
• Approves and processes assigned claims and manages action plan per contract.
• Manages subrogation of claims and negotiates settlements.
• Communicates claim actions with claimants and clients.
• Ensures claim files are properly documented and claims coding is correct.
• May process complex lifetime medical or defined period medical claims and related filings.
• Maintains professional client relationships.

Skills

Claims adjudication

Workers' comp knowledge

Education

Bachelor's degree

Job description

Sedgwick is seeking a Claims Adjuster for Workers’ Compensation with jurisdiction coverage in MI, TX, IN, IL, and OH. Remote, full-time role requiring licensing and home-state compliance.

You will adjudicate complex claims, determine benefits, and negotiate settlements for a global leader in risk and claims management. Ideal candidates have 4+ years in claims management, a Bachelor's degree, and familiarity with workers’ compensation regulations.