Remote Workers' Comp Claims Examiner (AK)

Sedgwick; Richmond (VA); Remote; USD 75,000 - 90,000; Full time

Benefits offered by this job

Flexible schedule

Referral incentive program

Agile environment

Career development

Comprehensive benefits

Job summary

Sedgwick, a global leader in risk and claims administration, seeks a Claims Examiner for Workers' Compensation with AK licensing. This remote role offers a stable office-like environment and a path to a professional career with growth opportunities.

Ideal candidates may have 5 years in claims management or an equivalent mix of education and experience. Flexible schedule and a comprehensive benefits package are provided, with AK-specific licensing emphasized.

Qualifications

• 5 years of claims management experience or equivalent combination of education and experience required.

Responsibilities

• Processes low level workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.
• Develops and coordinates low level workers compensation claims' action plans to resolution, return-to-work efforts, and approves claim payments.
• Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract.
• Administers subrogation of claims and negotiates settlements.
• Communicates claim action with claimant and client.
• Ensures claim files are properly documented and claims coding is correct.
• May process low-level lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
• Maintains professional client relationships.

Skills

claims management

Education

High School Diploma or GED

Bachelor's degree preferred

Job description

Sedgwick, a global leader in risk and claims administration, seeks a Claims Examiner for Workers' Compensation with AK licensing. This remote role offers a stable office-like environment and a path to a professional career with growth opportunities.

Ideal candidates may have 5 years in claims management or an equivalent mix of education and experience. Flexible schedule and a comprehensive benefits package are provided, with AK-specific licensing emphasized.