Remote Workers’ Compensation Claims Examiner

Sedgwick; Pierre (SD); Remote; USD 64,000 - 85,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Agile environment

Job summary

Sedgwick is seeking a Claims Examiner for Workers’ Compensation to adjudicate complex claims and determine benefits in line with client requirements. The role offers flexibility and autonomy in a supportive culture with opportunities for career growth.

The ideal candidate brings 5 years of claims management experience and a solid understanding of OR regulatory requirements, with remote/hybrid work options and comprehensive benefits.

Qualifications

• Education & Licensing: High School Diploma or GED required.
• Bachelor’s degree from an accredited college or university preferred.
• Professional certification as applicable to line of business preferred.
• Experience: 5 years of claims management experience or equivalent combination of education and experience required.
• Licensing / Jurisdiction Knowledge: OR

Responsibilities

• Analyzing and processing claims through well-developed action plans to a 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.

Skills

5 years of claims management

Education

High School Diploma or GED

Bachelor’s degree (preferred)

Professional certification (as applicable)

Job description

Sedgwick is seeking a Claims Examiner for Workers’ Compensation to adjudicate complex claims and determine benefits in line with client requirements. The role offers flexibility and autonomy in a supportive culture with opportunities for career growth.

The ideal candidate brings 5 years of claims management experience and a solid understanding of OR regulatory requirements, with remote/hybrid work options and comprehensive benefits.