Remote Workers' Comp Claims Examiner (NJ/PA/VA/MA)

Sedgwick Claims Management Services Ltd; New Jersey; Remote; USD 80,000 - 85,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development and growth

Job summary

Sedgwick Claims Management Services Ltd. is hiring a Workers Compensation Claims Examiner to analyze Medical Only & Lost-Time claims across NJ, PA, VA and MA. You will adjudicate, determine benefits due, and maintain service expectations under client requirements.

The role offers flexibility as a telecommuter in NJ, with opportunities for professional growth and a comprehensive benefits package. A strong emphasis on accurate investigation and timely communication supports client satisfaction.

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: 2+ years of claims management experience or equivalent combination of education and experience.

Responsibilities

• Analyzing and processing claims through well-developed action plans to determine exposure and ensure timely resolution.
• Negotiating settlements within designated authority.
• Communicating claim activity with the claimant and the client.
• Reporting claims to the excess carrier and responding to directions in a professional and timely manner.

Skills

Claims adjudication

Customer service

Negotiation

Investigation

Education

High School Diploma or GED

Bachelor's degree preferred

Professional certification (as applicable)

Job description

Sedgwick Claims Management Services Ltd. is hiring a Workers Compensation Claims Examiner to analyze Medical Only & Lost-Time claims across NJ, PA, VA and MA. You will adjudicate, determine benefits due, and maintain service expectations under client requirements.

The role offers flexibility as a telecommuter in NJ, with opportunities for professional growth and a comprehensive benefits package. A strong emphasis on accurate investigation and timely communication supports client satisfaction.