Remote Workers' Compensation Claims Examiner

Sedgwick; Clayton (NC); Remote; USD 70,000 - 75,000; Full time

Benefits offered by this job

Medical, dental, vision

401(k) on day one

PTO

Disability & life insurance

Employee assistance

FSA/HSA

Referral incentives

Career development

Job summary

Sedgwick is a global leader in risk, claims, and outsourced solutions. The role focuses on analyzing Lost-Time Workers’ Compensation claims for major clients, determining benefits, and ensuring timely adjudication in line with client requirements and industry best practices.

You will adjudicate complex claims, negotiate settlements, and maintain proactive communication with claimants and clients, while leveraging Sedgwick’s diverse network and development opportunities.

Qualifications

• Education: High School Diploma or GED required. Bachelor's degree preferred. Professional certification as applicable to line of business preferred.
• Experience: 5 years of claims management experience or equivalent combo of education and experience required.
• Heavy Litigation - experience required.

Responsibilities

• Analyzing and processing Lost-Time Workers Compensation claims to determine benefits due and adjudicate within service levels.
• Negotiating settlements within designated authority.
• Communicating claim activity with the claimant and client.
• Reporting claims to the excess carrier and responding to directions timely.

Skills

Claims management

Litigation experience

Education

High School Diploma or GED

Bachelor's degree preferred

Professional certification appropriate to the line of business

Job description

Sedgwick is a global leader in risk, claims, and outsourced solutions. The role focuses on analyzing Lost-Time Workers’ Compensation claims for major clients, determining benefits, and ensuring timely adjudication in line with client requirements and industry best practices.

You will adjudicate complex claims, negotiate settlements, and maintain proactive communication with claimants and clients, while leveraging Sedgwick’s diverse network and development opportunities.