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

Agile environment

Career development opportunities

Medical, dental, vision, 401K on day 1

Job summary

Sedgwick is seeking a Claims Examiner - Workers' Compensation to analyze complex workers' compensation claims for clients, determine benefits, and ensure adjudication aligns with service standards. This remote role offers flexibility, autonomy in daily work, and opportunities to grow within a global leader.

The role emphasizes adjudication, negotiation, and timely communication with claimants and clients, with a focus on OR jurisdiction knowledge and comprehensive benefits packages.

Qualifications

• Education & Licensing: High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred.
• Experience: 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 adjudication

Negotiation

Client communication

Analytical thinking

Education

High School Diploma or GED

Bachelor’s degree preferred

Professional certification relevant to line of business preferred

Job description

Sedgwick is seeking a Claims Examiner - Workers' Compensation to analyze complex workers' compensation claims for clients, determine benefits, and ensure adjudication aligns with service standards. This remote role offers flexibility, autonomy in daily work, and opportunities to grow within a global leader.

The role emphasizes adjudication, negotiation, and timely communication with claimants and clients, with a focus on OR jurisdiction knowledge and comprehensive benefits packages.