Remote Workers' Comp Claims Examiner I

Sedgwick; Clayton (NC); Remote; USD 60,000 - 85,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Agile environment

Career development and growth

Comprehensive benefits

Job summary

Sedgwick is seeking a remote Claims Examiner I to analyze workers' compensation claims on behalf of clients, applying adjudication standards and service expectations. You will determine benefits due and support timely, accurate resolutions in a dynamic work environment.

Ideal candidates have 5+ years in claims management, a high school diploma or GED (Bachelor's degree preferred), and licensing knowledge for FL, GA, NC, or SC. Flexible work and strong development opportunities are provided.

Qualifications

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

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

Claims management experience

Negotiation

Client communication

Education

High School Diploma or GED

Bachelor's degree preferred

Professional certification as applicable

Licensing knowledge FL/GA/NC/SC

Job description

Sedgwick is seeking a remote Claims Examiner I to analyze workers' compensation claims on behalf of clients, applying adjudication standards and service expectations. You will determine benefits due and support timely, accurate resolutions in a dynamic work environment.

Ideal candidates have 5+ years in claims management, a high school diploma or GED (Bachelor's degree preferred), and licensing knowledge for FL, GA, NC, or SC. Flexible work and strong development opportunities are provided.