Remote Workers' Comp Claims Examiner (WA/OR)

Sedgwick Claims Management Services Ltd; Oregon; Hybrid; USD 70,000 - 90,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development

Comprehensive benefits

Job summary

Sedgwick is seeking a Claims Examiner - Workers' Compensation to analyze workers' compensation claims for clients, determine benefits due, and adjudicate within service expectations and client requirements. This role utilizes Sedgwick's global network, prioritizing accuracy, timely action, and professional communication.

Candidates should have a high school diploma or GED (Bachelor's preferred), 5 years’ claims experience, WWCP or Oregon certification, and WA/OR jurisdiction knowledge.

Qualifications

• High School Diploma or GED required; Bachelor's degree preferred.
• Professional certification as applicable to line of business preferred.
• 5 years of claims management experience or equivalent combination of education and experience required.
• Licensing: WWCP or Oregon Workers’ Compensation Claims Examiner Certification.
• Jurisdiction Knowledge: WA or OR.

Responsibilities

• Analyzing and processing claims to determine exposure and resolve them timely according to client requirements.
• Negotiating settlements within designated authority.
• Communicating claim activity and processing with the claimant and the client.
• Reporting claims to the excess carrier and responding to directions in a professional and timely manner.

Skills

Analytical thinking

Negotiation

Communication

Education

High School Diploma or GED

Bachelor's degree preferred

WWCP or Oregon Certification

Job description

Sedgwick is seeking a Claims Examiner - Workers' Compensation to analyze workers' compensation claims for clients, determine benefits due, and adjudicate within service expectations and client requirements. This role utilizes Sedgwick's global network, prioritizing accuracy, timely action, and professional communication.

Candidates should have a high school diploma or GED (Bachelor's preferred), 5 years’ claims experience, WWCP or Oregon certification, and WA/OR jurisdiction knowledge.