Remote Workers' Comp Claims Examiner

Sedgwick Claims Management Services Ltd; San Antonio (TX); Hybrid; USD 52,000 - 76,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401K on day one

Flexible schedule

Career development

Job summary

Sedgwick is seeking a dedicated Claims Examiner to analyze workers' compensation claims for clients across multiple jurisdictions. You will determine benefits due and adjudicate claims in line with client service requirements, while maintaining timely and accurate communications with claimants and providers.

This hybrid/remote role offers flexible scheduling, comprehensive benefits, and opportunities for professional growth within a global leader known for caring counts and exceptional customer

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: FL required, CA preferred.
• Jurisdiction: CA, FL, GA, MS, MI, NJ, OK, PA, TN, TX, VI

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

Negotiation

Communication

Education

High School Diploma or GED

Bachelor's degree

Job description

Sedgwick is seeking a dedicated Claims Examiner to analyze workers' compensation claims for clients across multiple jurisdictions. You will determine benefits due and adjudicate claims in line with client service requirements, while maintaining timely and accurate communications with claimants and providers.

This hybrid/remote role offers flexible scheduling, comprehensive benefits, and opportunities for professional growth within a global leader known for caring counts and exceptional customer