Remote Workers' Comp Claims Examiner - Impact & Growth

Sedgwick; Milton (MA); Remote; USD 80,000 - 90,000; Full time

Benefits offered by this job

Medical, dental, vision

401K on day one

PTO and life insurance

Job summary

Sedgwick is hiring a Lost-Time Workers Compensation Claims Examiner to analyze and adjudicate complex claims for multiple jurisdictions. You will determine benefits due, maintain service standards, and collaborate with clients in a fast-paced, flexible environment.

Ideal candidates have 5+ years in claims management, strong negotiation and communication skills, and a commitment to high-quality client service. Jurisdiction knowledge includes MA, CT, NH, RI, VT, with licensing per jurisdiction.

Qualifications

• Education: High School Diploma or GED required; Bachelor's degree preferred; Professional certification as applicable to line of business.
• Experience: 5 years of claims management experience or equivalent combination of education and experience.
• Licensing: MA, CT, NH, RI, VT knowledge; VT, CT, NH, RI licensing.

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

Adjudication

Negotiation

Client communication

Analytical thinking

Education

High School Diploma or GED

Bachelor's degree preferred

Professional certification (line of business)

Job description

Sedgwick is hiring a Lost-Time Workers Compensation Claims Examiner to analyze and adjudicate complex claims for multiple jurisdictions. You will determine benefits due, maintain service standards, and collaborate with clients in a fast-paced, flexible environment.

Ideal candidates have 5+ years in claims management, strong negotiation and communication skills, and a commitment to high-quality client service. Jurisdiction knowledge includes MA, CT, NH, RI, VT, with licensing per jurisdiction.