Remote Workers' Compensation Claims Examiner - Growth Path

Sedgwick; Seattle (WA); Remote; USD 75,000 - 90,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401K with company match

Paid time off

Job summary

Sedgwick is hiring for a Claims Examiner - Workers Compensation, remote with jurisdiction AK. The role processes low level claims, adjudicates benefits, and negotiates settlements under supervision while maintaining client relationships.

The ideal candidate has 5+ years of claims management experience, a high school diploma or GED, and preferably a bachelor’s degree. Flexible scheduling and comprehensive benefits are offered.

Qualifications

• 5 years of claims management experience or equivalent combination of education and experience required.
• High School Diploma or GED required; Bachelor’s degree preferred.
• Professional certification as applicable to line of business preferred.

Responsibilities

• Processes low level workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.
• Develops and coordinates low level workers compensation claims' action plans to resolution, return-to-work efforts, and approves claim payments.
• Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract.
• Administers subrogation of claims and negotiates settlements.
• Communicates claim action with claimant and client.
• Ensures claim files are properly documented and claims coding is correct.
• May process low-level lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
• Maintains professional client relationships.

Skills

Claims management

Communication skills

Education

High School Diploma or GED

Bachelor's degree preferred

Job description

Sedgwick is hiring for a Claims Examiner - Workers Compensation, remote with jurisdiction AK. The role processes low level claims, adjudicates benefits, and negotiates settlements under supervision while maintaining client relationships.

The ideal candidate has 5+ years of claims management experience, a high school diploma or GED, and preferably a bachelor’s degree. Flexible scheduling and comprehensive benefits are offered.