Remote Workers' Compensation Claims Examiner (NY)

Sedgwick; Concord (NH); Remote; USD 90,000 - 95,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Remote work environment

Career development

Benefits package

Job summary

Sedgwick, a global leader in risk and claims administration, seeks a dedicated Claims Examiner for NY jurisdictional work in a remote setting. You will analyze workers' compensation claims, determine benefits, and ensure timely adjudication while collaborating with clients and internal teams.

The role emphasizes strong negotiation, strong communication, and adherence to client service standards and regulatory requirements.

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: 3-5 years of claims management experience or equivalent combination of education and experience required.
• Public Entity Workers Compensation preferred
• Jurisdiction Knowledge: NY Required; NJ Preferred
• Licensing: NY

Responsibilities

• Analyze Lost-Time Workers Compensation claims to determine benefits due and adjudicate within service expectations and client requirements.
• Negotiate settlements within designated authority.
• Communicate claim activity with claimants and clients; document progress.
• Report claims to excess carrier and respond to directions in a timely manner.

Skills

Claims management

Investigation

Negotiation

Communication

Education

High School Diploma or GED

Bachelor's degree preferred

Job description

Sedgwick, a global leader in risk and claims administration, seeks a dedicated Claims Examiner for NY jurisdictional work in a remote setting. You will analyze workers' compensation claims, determine benefits, and ensure timely adjudication while collaborating with clients and internal teams.

The role emphasizes strong negotiation, strong communication, and adherence to client service standards and regulatory requirements.