Remote Workers' Comp Claims Examiner

Sedgwick; Frankfort (KY); Hybrid; USD 70,000 - 85,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentives

Agile environment

Career development

Medical, dental, vision, 401K

Job summary

Sedgwick is seeking a Claims Examiner for Workers' Compensation to analyze complex claims and determine benefits due, while ensuring timely adjudication aligned with client requirements. The role offers flexibility in location and career growth within a global leader in risk and claims management.

The ideal candidate has 5 years of claims management experience, a high school diploma or GED, and a preferred Bachelor's degree with licensing in the home state.

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: 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

WC knowledge

Claims adjudication

Negotiation

Communication

Time management

Education

High School Diploma or GED

Bachelor's degree preferred

Job description

Sedgwick is seeking a Claims Examiner for Workers' Compensation to analyze complex claims and determine benefits due, while ensuring timely adjudication aligned with client requirements. The role offers flexibility in location and career growth within a global leader in risk and claims management.

The ideal candidate has 5 years of claims management experience, a high school diploma or GED, and a preferred Bachelor's degree with licensing in the home state.