Remote Workers' Comp Claims Specialist

Sedgwick Claims Management Services Ltd; Alabama; Hybrid; USD 60,000 - 75,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Agile environment

Career development

Benefits including medical, dental, 4

Job summary

Sedgwick Claims Management Services Ltd seeks a Claims Adjuster for Workers Compensation. Work remotely across the United States with licensing and jurisdiction requirements.

The ideal candidate will analyze mid to high complex claims, determine benefits, and pursue subrogation while maintaining accurate documentation and client communications. The role requires four years of claims management experience, a bachelor’s degree, and active home-state licensing.

Qualifications

• Bachelor's degree from an accredited college or university preferred.
• Four (4) years of claims management experience or equivalent.
• Jurisdiction knowledge: MI, TX, IN, IL, OH.
• Home State licensing required.

Responsibilities

• Manages workers compensation claims determining compensability and benefits due on long term indemnity claims.
• Develops and manages workers compensation claims' action plans to resolution, coordinates return-to-work efforts, and approves claim payments.
• Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.
• Manages subrogation of claims and negotiates settlements.
• Communicates claim action with claimant and client.
• Ensures claim files are properly documented and claims coding is correct.

Education

Bachelor's degree from an accredited college or university preferred.

Job description

Sedgwick Claims Management Services Ltd seeks a Claims Adjuster for Workers Compensation. Work remotely across the United States with licensing and jurisdiction requirements.

The ideal candidate will analyze mid to high complex claims, determine benefits, and pursue subrogation while maintaining accurate documentation and client communications. The role requires four years of claims management experience, a bachelor’s degree, and active home-state licensing.