Remote Workers' Comp Claims Examiner - Adjudicate & Resolve

Sedgwick Claims Management Services Ltd; Northern (KY); Hybrid; USD 63,000 - 89,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401K with match

PTO

Disability insurance

Life insurance

Employee assistance program

HSA/FSA

Job summary

Sedgwick is seeking a Claims Examiner for Workers' Compensation in the Southeast states. You will analyze claims to determine due benefits and adjudicate efficiently while maintaining service standards. This role offers flexible work arrangements and strong professional growth.

Ideal candidates have 5 years of claims experience, a home state license for the Southeast, and a Bachelor’s degree is preferred. Sedgwick provides comprehensive benefits including medical, dental, vision, 401(k), and PTO.

Qualifications

• High School Diploma or GED required; Bachelor's degree preferred; professional certification as applicable to line of business.
• 5 years of claims management experience or equivalent combination of education and experience.
• Home state license required, Southeast States.

Responsibilities

• Analyze workers' compensation claims to determine benefits due and adjudicate within service expectations.
• 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 management

Analytical thinking

Negotiation

Communication

Attention to detail

Education

High School Diploma or GED

Bachelor's degree preferred

Tools

Claims software

Job description

Sedgwick is seeking a Claims Examiner for Workers' Compensation in the Southeast states. You will analyze claims to determine due benefits and adjudicate efficiently while maintaining service standards. This role offers flexible work arrangements and strong professional growth.

Ideal candidates have 5 years of claims experience, a home state license for the Southeast, and a Bachelor’s degree is preferred. Sedgwick provides comprehensive benefits including medical, dental, vision, 401(k), and PTO.