Remote Workers' Comp Claims Examiner

Sedgwick; Columbus (OH); Hybrid; USD 70,000 - 85,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development opportunities

Medical, dental, vision + 401K on day

Job summary

Sedgwick is hiring a Claims Examiner for Workers’ Compensation to analyze claims, determine benefits due, and adjudicate within client requirements. The role supports a hybrid model with 2 in-office days and 3 remote days, based on proximity to Sedgwick offices.

Strong emphasis on timely resolution and adherence to service standards is expected. Ideal candidates have at least 5 years in claims management, with home-state licensing preferred and MD/NJ jurisdiction knowledge.

Qualifications

• High School Diploma or GED required.
• Bachelor's degree from an accredited college or university preferred.
• 5 years of claims management experience or equivalent combination of education and experience required.
• Licensing: Home state preferred.
• Jurisdiction Knowledge: MD and NJ

Responsibilities

• Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
• Negotiating settlement of claims within designated authority.
• Communicating claim activity and processing with the claimant and the client.
• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

Skills

Analytical thinking

Communication skills

Negotiation

Problem solving

Education

Bachelor's degree preferred

High School Diploma or GED

Tools

Licensing knowledge

Job description

Sedgwick is hiring a Claims Examiner for Workers’ Compensation to analyze claims, determine benefits due, and adjudicate within client requirements. The role supports a hybrid model with 2 in-office days and 3 remote days, based on proximity to Sedgwick offices.

Strong emphasis on timely resolution and adherence to service standards is expected. Ideal candidates have at least 5 years in claims management, with home-state licensing preferred and MD/NJ jurisdiction knowledge.