Remote Workers' Comp Claims Examiner — Growth & Impact

Sedgwick; Clifton (TX); Remote; USD 70,000 - 75,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development and promotional成长

Job summary

Sedgwick is seeking an experienced Loss-Time Workers Compensation claims examiner to analyze complex cases for multiple clients across the United States, including Texas. You will adjudicate benefits, manage investigations, and ensure service expectations are met with accuracy and discretion.

The role emphasizes strong negotiation, communication with claimants and clients, and collaboration across teams to deliver timely, customer-focused resolutions.

Qualifications

• High School Diploma or GED required; Bachelor's degree preferred; Professional certification as applicable to line of business preferred.
• 5 years of claims management experience or equivalent combination of education and experience required.
• Heavy Litigation - experience required.
• Jurisdiction Knowledge: DE, IL, LA, MO, NJ, OK, TN, TX.
• Licensing: Home state plus DE, LA, OK, TX.

Responsibilities

• Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
• 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 requests of directions in a professional and timely manner.

Skills

Analytical thinking

Negotiation

Communication

Cross-functional collaboration

Education

High School Diploma or GED

Bachelor's degree preferred

Professional certification where applicable

Job description

Sedgwick is seeking an experienced Loss-Time Workers Compensation claims examiner to analyze complex cases for multiple clients across the United States, including Texas. You will adjudicate benefits, manage investigations, and ensure service expectations are met with accuracy and discretion.

The role emphasizes strong negotiation, communication with claimants and clients, and collaboration across teams to deliver timely, customer-focused resolutions.