Senior Workers' Comp Claims Specialist

Sedgwick; United States; Remote; USD 47,000 - 57,000; Full time

Job summary

Sedgwick is hiring a Workers’ Compensation Consultant – Level 3 to analyze complex claims and determine benefits due for executives. You’ll work with high-exposure cases, coordinate with clients, and guide return-to-work plans while ensuring compliance with regulations and client contracts.

Ideal candidates have 4+ years in claims management, strong negotiation and communications skills, and proficiency with Microsoft Office.

Qualifications

• Bachelor's degree (preferred) from an accredited college/university.
• Four or more years of claims management experience.
• Strong knowledge of regulations, benefits, and medical management practices.
• Excellent written and verbal communication, including presentations.

Responsibilities

• Analyze complex workers' compensation claims to determine benefits due.
• Manage claims with high exposure, including litigation and rehab.
• Ensure adjudication aligns with service expectations and client requirements.
• Identify subrogation opportunities and negotiate settlements.
• Maintain accurate claim documentation and communicate with claimants and clients.
• Support quality programs and travel as required.

Skills

Communication skills

Negotiation

Teamwork

Analytical thinking

Organizational skills

Interpersonal skills

Oral & written communication

Education

Bachelor's degree from accredited college/university

Tools

Microsoft Office

Job description

Sedgwick is hiring a Workers’ Compensation Consultant – Level 3 to analyze complex claims and determine benefits due for executives. You’ll work with high-exposure cases, coordinate with clients, and guide return-to-work plans while ensuring compliance with regulations and client contracts.

Ideal candidates have 4+ years in claims management, strong negotiation and communications skills, and proficiency with Microsoft Office.