Remote Workers' Comp Claims Examiner

Sedgwick Claims Management Services Ltd; Yorkmont (NC); Hybrid; USD 55,000 - 75,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development and promotional 성장

Job summary

Sedgwick Claims Management Services Ltd seeks a committed Claims Examiner to analyze Workers’ Compensation claims for our clients, determining benefits due and adjudicating within service standards. You will work with clients to ensure fair, timely decisions and maintain professional communication throughout the process.

The role emphasizes thorough analysis, accurate documentation, and coordination with carriers, clients, and claimants to manage risk and deliver exceptional customer service in

Qualifications

• High School Diploma or GED required; Bachelor's degree preferred.
• 5 years of claims management experience or equivalent.
• Licensing knowledge for SC & NC.

Responsibilities

• Analyze and process workers' compensation claims to determine benefits and resolve within service expectations.
• Negotiate settlements within designated authority.
• Communicate claim activity with claimants and clients.
• Report claims to excess carriers and respond to directions promptly.

Skills

Claims management

Negotiation

Analysis

Communication

Education

High School Diploma or GED

Bachelor's degree preferred

Professional certification (line of business)

Job description

Sedgwick Claims Management Services Ltd seeks a committed Claims Examiner to analyze Workers’ Compensation claims for our clients, determining benefits due and adjudicating within service standards. You will work with clients to ensure fair, timely decisions and maintain professional communication throughout the process.

The role emphasizes thorough analysis, accurate documentation, and coordination with carriers, clients, and claimants to manage risk and deliver exceptional customer service in