Remote Workers' Comp Claims Specialist

Sedgwick Claims Management Services Ltd; West Virginia; Hybrid; USD 58,000 - 63,000; Full time

Benefits offered by this job

Medical, dental, vision

401K on day one

Paid time off

Job summary

Sedgwick is hiring a Workers Compensation Claims Representative to analyze Lost-Time claims for major clients. You will determine benefits due, manage adjudication within service standards, and coordinate with claimants and clients. The role emphasizes accuracy, timely processing, and client service in a remote setup.

Ideal candidates will have 1 year of claims experience, a high school diploma or GED, and WV knowledge. Bachelor’s degree preferred; licensing is not required.

Qualifications

• High School Diploma or GED required.
• Bachelor's degree preferred.
• Professional certification as applicable to line of business preferred.
• 1 year of claims management experience required.
• WV jurisdiction preferred; Licensing not required.

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.

Education

High School Diploma or GED

Bachelor's degree

Professional certification

Job description

Sedgwick is hiring a Workers Compensation Claims Representative to analyze Lost-Time claims for major clients. You will determine benefits due, manage adjudication within service standards, and coordinate with claimants and clients. The role emphasizes accuracy, timely processing, and client service in a remote setup.

Ideal candidates will have 1 year of claims experience, a high school diploma or GED, and WV knowledge. Bachelor’s degree preferred; licensing is not required.