Remote Workers' Comp Claims Specialist

Sedgwick Claims Management Services Ltd; North Carolina; Hybrid; USD 55,000 - 71,000; Full time

Benefits offered by this job

Flexible schedule

Referral incentives

Agile environment

Career development

Health benefits, 401k on day one

Job summary

Sedgwick is seeking a Claims Examiner to analyze workers' compensation claims for our clients, determine benefits due, and adjudicate claims within service expectations and client requirements.

The ideal candidate will have robust claims experience, strong negotiation and communication skills, and the ability to work in a hybrid environment across multiple jurisdictions. Sedgwick offers professional development, comprehensive benefits, and a supportive culture emphasizing growth and inclusion.

Qualifications

• High School Diploma or GED required; a Bachelor’s degree preferred.
• 4 years of claims management experience or an equivalent combination of education and experience.
• Licensing: FL required; jurisdiction knowledge: FL, AZ, TN.

Responsibilities

• Analyzing and processing claims through established action plans to determine exposure and achieve timely resolution.
• 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 directions in a timely professional manner.

Skills

Claims management

Negotiation

Communication

Investigation

Analytical thinking

Education

High School Diploma or GED

Bachelor’s degree preferred

Professional certification relevant to line of business

Job description

Sedgwick is seeking a Claims Examiner to analyze workers' compensation claims for our clients, determine benefits due, and adjudicate claims within service expectations and client requirements.

The ideal candidate will have robust claims experience, strong negotiation and communication skills, and the ability to work in a hybrid environment across multiple jurisdictions. Sedgwick offers professional development, comprehensive benefits, and a supportive culture emphasizing growth and inclusion.