Remote Workers' Comp Claims Examiner

Sedgwick; Dover (DE); Remote; USD 64,000 - 85,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Comprehensive benefits

Job summary

Sedgwick is seeking a Claims Examiner for Workers' Compensation to analyze complex claims on behalf of our clients and determine benefits due, while ensuring adjudication aligns with service expectations and industry best practices.

You will work in a flexible, hybrid/remote environment with opportunities to grow within a global leader in risk and claims administration. OR licensing experience is preferred, and the role supports career development across diverse client projects.

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/Jurisdiction Knowledge: OR

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

Claims management experience

Education

High School Diploma or GED

Bachelor's degree

Job description

Sedgwick is seeking a Claims Examiner for Workers' Compensation to analyze complex claims on behalf of our clients and determine benefits due, while ensuring adjudication aligns with service expectations and industry best practices.

You will work in a flexible, hybrid/remote environment with opportunities to grow within a global leader in risk and claims administration. OR licensing experience is preferred, and the role supports career development across diverse client projects.