Remote Workers' Comp Claims Examiner – Adjudicate & Settle

Sedgwick; Illinois; Remote; USD 70,000 - 75,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development opportunities

Comprehensive benefits: medical,Dental

Job summary

Sedgwick is seeking a experienced Lost-Time Workers' Compensation Claims Examiner to adjudicate complex claims for clients across multiple jurisdictions. You will analyze claims, determine benefits due, and maintain service standards while leveraging a broad network of experts.

The role emphasizes negotiation, timely communication with claimants and clients, and comprehensive reporting to carriers. A strong attention to detail and 5 years of claims experience are essential for success.

Qualifications

• 5 years of claims management experience or equivalent combination of education and experience required.
• 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.
• Licensing: Home state plus DE, LA, OK, TX required.

Responsibilities

• Analyzing and processing Lost-Time Workers Compensation claims to determine exposure, within client service expectations.
• 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 directions in a timely manner.

Skills

Analytical thinking

Negotiation

Communication skills

Attention to detail

Education

High School Diploma or GED

Bachelor's degree preferred

Job description

Sedgwick is seeking a experienced Lost-Time Workers' Compensation Claims Examiner to adjudicate complex claims for clients across multiple jurisdictions. You will analyze claims, determine benefits due, and maintain service standards while leveraging a broad network of experts.

The role emphasizes negotiation, timely communication with claimants and clients, and comprehensive reporting to carriers. A strong attention to detail and 5 years of claims experience are essential for success.