Remote Workers' Comp Claims Examiner — Growth & Impact

Sedgwick Claims Management Services Ltd; Plano (TX); Hybrid; USD 60,000 - 85,000; Full time

Job summary

Sedgwick is seeking a Claims Examiner - Workers Compensation to analyze claims for our clients, determine benefits, and adjudicate within service expectations. This role emphasizes collaboration with clients and adherence to industry best practices.

Ideal candidates bring 5 years of claims management experience, a High School Diploma or GED, and licensing knowledge for TX and OK. The position supports a flexible, hybrid/remote work environment and ongoing professional development.

Qualifications

• Education & Licensing: 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.
• Experience: 5 years of claims management experience or equivalent combination of education and experience required.
• Licensing / Jurisdiction Knowledge: TX, OK

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.

Education

High School Diploma or GED

Bachelor's degree preferred

Professional certification

Job description

Sedgwick is seeking a Claims Examiner - Workers Compensation to analyze claims for our clients, determine benefits, and adjudicate within service expectations. This role emphasizes collaboration with clients and adherence to industry best practices.

Ideal candidates bring 5 years of claims management experience, a High School Diploma or GED, and licensing knowledge for TX and OK. The position supports a flexible, hybrid/remote work environment and ongoing professional development.