Remote Workers' Comp Claims Examiner I

Sedgwick Claims Management Services Inc.; United States; Remote; USD 60,000 - 85,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Opportunity to work in an agile/remote

Career development and growth

Comprehensive benefits including med/d

Job summary

Sedgwick Claims Management Services Inc. is seeking a remote Claims Examiner I for Workers' Compensation to adjudicate complex claims and determine benefits in line with client service expectations.

The role emphasizes analytical investigation, negotiation within authority, and clear communication with claimants and clients across multiple states. The ideal candidate has 5 years of claims management experience or an equivalent mix of education and experience, a high school diploma or GED, and

Qualifications

• 5 years of claims management experience or equivalent combination of education and experience.
• High School Diploma or GED required; Bachelor’s degree 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 knowledge

Negotiation

Communication

Education

5 years of claims management experience

High School Diploma or GED

Bachelor’s degree preferred

Job description

Sedgwick Claims Management Services Inc. is seeking a remote Claims Examiner I for Workers' Compensation to adjudicate complex claims and determine benefits in line with client service expectations.

The role emphasizes analytical investigation, negotiation within authority, and clear communication with claimants and clients across multiple states. The ideal candidate has 5 years of claims management experience or an equivalent mix of education and experience, a high school diploma or GED, and