Remote Workers' Comp Claims Adjuster — Growth & Impact

Sedgwick; United States; Remote; USD 60,000 - 85,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development opportunities

Comprehensive benefits (medical,Dental

Job summary

Sedgwick is a global industry leader seeking a detail‑oriented Claims Adjuster for Workers' Compensation. You will analyze mid- to high‑level claims to determine benefits due, ensure adjudication aligns with standards, and identify subrogation opportunities while negotiating settlements.

The role emphasizes rigorous documentation, timely action plans, and coordination with claimants, clients, and internal teams to ensure accurate, compliant resolutions.

Qualifications

• Bachelor's degree from accredited college; 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: TX, MN, MI; Licensing: TX.

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 from an accredited college or university; professional certification as applicable to line of business preferred.

Job description

Sedgwick is a global industry leader seeking a detail‑oriented Claims Adjuster for Workers' Compensation. You will analyze mid- to high‑level claims to determine benefits due, ensure adjudication aligns with standards, and identify subrogation opportunities while negotiating settlements.

The role emphasizes rigorous documentation, timely action plans, and coordination with claimants, clients, and internal teams to ensure accurate, compliant resolutions.