Remote Workers’ Compensation Claims Adjudicator

Sedgwick; Salem (OR); Remote; USD 60,000 - 85,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Agile environment

Career development

Job summary

Sedgwick is hiring a remote Claims Adjuster - Workers Compensation to adjudicate mid- and high-level claims across assigned jurisdictions. You will determine benefits due, manage action plans, and coordinate return-to-work while maintaining client communications and proper documentation.

The ideal candidate has 4 years of claims management experience, a Bachelor's degree, and TX licensing (or Home State). Sedgwick offers a flexible schedule and strong career growth opportunities.

Qualifications

• Bachelor's degree preferred.
• Four (4) years of claims management experience or equivalent combination required.
• Licensing: TX or Home State; Jurisdiction TX, MN, MI knowledge.

Responsibilities

• Analyze mid- and higher-level workers compensation claims to determine benefits due.
• Ensure adjudication within company standards and industry best practices.
• Identify subrogation and negotiate settlements.
• Manage subrogation of claims and negotiate settlements.
• Communicate claim action with claimant and client.
• Ensure claim files are properly documented and coded.
• Handle complex lifetime medical or defined period medical claims when appropriate.
• Maintain professional client relationships.

Skills

Claims adjudication

Workers' compensation

Analytical thinking

Communication

Education

Bachelor's degree

Tools

Claims management system

Job description

Sedgwick is hiring a remote Claims Adjuster - Workers Compensation to adjudicate mid- and high-level claims across assigned jurisdictions. You will determine benefits due, manage action plans, and coordinate return-to-work while maintaining client communications and proper documentation.

The ideal candidate has 4 years of claims management experience, a Bachelor's degree, and TX licensing (or Home State). Sedgwick offers a flexible schedule and strong career growth opportunities.