Remote Workers' Comp Claims Examiner | Flexible Schedule

Sedgwick; Augusta (ME); A distancia; USD 75.000 - 90.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Flexible schedule

Referral program

Career growth

Benefits package

Descripción de la vacante

Sedgwick is seeking a Claims Examiner - Workers Compensation (AK) in a remote-capable role. The position processes low-level workers compensation claims, adjudicates benefits, and coordinates subrogation with general supervision.

Ideal candidates embody empathy and collaboration with a focus on accuracy, documentation, and client communication, within a flexible, growth-oriented environment.

Formación

• Education & Licensing: 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.

Responsabilidades

• 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.

Educación

High School Diploma or GED

Bachelor's degree

Descripción del empleo

Sedgwick is seeking a Claims Examiner - Workers Compensation (AK) in a remote-capable role. The position processes low-level workers compensation claims, adjudicates benefits, and coordinates subrogation with general supervision.

Ideal candidates embody empathy and collaboration with a focus on accuracy, documentation, and client communication, within a flexible, growth-oriented environment.