Remote Workers' Compensation Claims Examiner

Sedgwick; San Juan (PR); Remote; USD 64,000 - 85,000; Full time

Benefits offered by this job

Flexible schedule

Referral program

Agile environment

Career growth

Benefits package

Job summary

Sedgwick is seeking a Claims Examiner for Workers’ Compensation to analyze and adjudicate complex claims, determine benefits due, and ensure timely service delivery across WA & OR jurisdictions. Remote-work options available, with licensing in OR preferred.

The role emphasizes structured investigations, collaboration with clients, and adherence to service levels, while offering flexibility, growth, and a comprehensive benefits package.

Qualifications

• Education: High School Diploma or GED required; Bachelor's degree preferred.
• 5 years of claims management experience or equivalent.
• Licensing/Jurisdiction knowledge: OR.
• Professional certification relevant to line of business preferred.

Responsibilities

• Analyze and process workers' compensation claims to determine exposure and benefits.
• Negotiate settlements within designated authority.
• Communicate claim activity with claimants and clients.
• Report claims to excess carriers and respond to directions professionally and timely.

Skills

WC claims handling

Claims adjudication

Client communication

Education

High School Diploma or GED

Bachelor's degree

Job description

Sedgwick is seeking a Claims Examiner for Workers’ Compensation to analyze and adjudicate complex claims, determine benefits due, and ensure timely service delivery across WA & OR jurisdictions. Remote-work options available, with licensing in OR preferred.

The role emphasizes structured investigations, collaboration with clients, and adherence to service levels, while offering flexibility, growth, and a comprehensive benefits package.