Remote Workers' Compensation Claims Adjuster

Sedgwick; Salem (OR); A distancia; USD 60.000 - 75.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical insurance

Dental insurance

Vision insurance

401(k) with company match

PTO

Descripción de la vacante

Sedgwick is seeking a Claims Adjuster for Workers' Compensation to analyze mid- to high-level claims and determine benefits due, ensuring adjudication within company standards. Remote work options and licensing requirements apply.

Ideal candidates will adjudicate complex claims, identify subrogation opportunities, and maintain strong client relationships while navigating state regulations and industry best practices.

Formación

• Bachelor's degree preferred.
• Four (4) years of claims management experience or equivalent.
• Jurisdiction knowledge MI, TX, IN, IL, OH.
• Licensing: Home State Required.

Responsabilidades

• Analyzes workers compensation claims to determine benefits due on long term indemnity claims.
• Develops and manages action plans to resolution, coordinates return-to-work efforts, and approves claim payments.
• Approves and processes assigned claims, determines benefits due, and manages action plans as per contract.
• Manages subrogation of claims and negotiates settlements.
• Communicates claim actions with claimants and clients.
• Ensures claim files are properly documented and claims coding is correct.
• May process complex lifetime medical and/or defined period medical claims and considerations.
• Maintains professional client relationships.

Educación

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

Professional certification as applicable to line of business preferred.

Descripción del empleo

Sedgwick is seeking a Claims Adjuster for Workers' Compensation to analyze mid- to high-level claims and determine benefits due, ensuring adjudication within company standards. Remote work options and licensing requirements apply.

Ideal candidates will adjudicate complex claims, identify subrogation opportunities, and maintain strong client relationships while navigating state regulations and industry best practices.