Remote Workers' Comp Claims Examiner

Sedgwick; Trenton (NJ); Remote; USD 63,000 - 89,000; Full time

Benefits offered by this job

Medical, dental, vision

401K with matching

Paid time off

Career development

Flexible work schedule

Job summary

Sedgwick is seeking a Claims Examiner for Workers' Compensation to adjudicate complex claims in a remote setting. You will analyze exposure, determine benefits due, and ensure adjudication aligns with client service requirements and industry best practices.

The role offers flexible work arrangements, opportunities for career development, and a comprehensive benefits package. A home-state license and 5 years of claims management experience are preferred, with Southeast States licensing knowledge

Qualifications

• High School Diploma or GED required; Bachelor's degree preferred.
• 5 years claims management experience.
• Home state license required; Southeast States knowledge preferred.

Responsibilities

• Analyze workers' compensation claims to determine benefits due.
• Adjudicate claims with service expectations and client requirements.
• Negotiate settlements within designated authority.
• Communicate claim activity with the claimant and the client.
• Report claims to the excess carrier and respond to directions in a professional and timely manner.

Skills

Claims handling

Negotiation

Regulatory knowledge

Education

High School Diploma or GED

Bachelor's degree preferred

Professional certification

Job description

Sedgwick is seeking a Claims Examiner for Workers' Compensation to adjudicate complex claims in a remote setting. You will analyze exposure, determine benefits due, and ensure adjudication aligns with client service requirements and industry best practices.

The role offers flexible work arrangements, opportunities for career development, and a comprehensive benefits package. A home-state license and 5 years of claims management experience are preferred, with Southeast States licensing knowledge