Remote Workers’ Comp Claims Adjuster | Growth & Benefits

Sedgwick; Augusta (ME); Remote; USD 60,000 - 75,000; Full time

Benefits offered by this job

Flexible schedule

Referral incentive program

Career development

Benefits package

Job summary

Sedgwick, a global leader in risk and claims administration, seeks a Claims Adjuster specialized in Workers’ Compensation. You’ll adjudicate mid- to high-level claims, determine benefits, oversee action plans, and manage subrogation while maintaining strong client relationships.

This remote role emphasizes accuracy, collaboration, and timely settlements. The position supports a flexible work schedule, career development, and a broad benefits package, with licensing requirements in applicable

Qualifications

• Education and Licensing: Bachelor's degree from an accredited college or university preferred.
• Experience: 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.

Education

Bachelor's degree

Job description

Sedgwick, a global leader in risk and claims administration, seeks a Claims Adjuster specialized in Workers’ Compensation. You’ll adjudicate mid- to high-level claims, determine benefits, oversee action plans, and manage subrogation while maintaining strong client relationships.

This remote role emphasizes accuracy, collaboration, and timely settlements. The position supports a flexible work schedule, career development, and a broad benefits package, with licensing requirements in applicable