Senior Workers' Compensation Claims Analyst

Sedgwick Claims Management Services Ltd; Southfield (MI); On-site; USD 65,000 - 90,000; Full time

Job summary

Sedgwick is seeking a Claims Examiner- Workers' Compensation to analyze complex claims, determine benefits, and manage high-exposure cases through adjudication and rehabilitation.

The role requires a Bachelor's degree and at least five years in claims management, with strong negotiation, analytical, and communication skills. You will work with clients, vendors, and internal teams to ensure timely resolutions and cost-effective outcomes.

Qualifications

• Bachelor's degree preferred.
• Five years of claims management experience or equivalent required.
• Professional certification applicable to line of business preferred.

Responsibilities

• Analyzes and processes complex workers' compensation claims to determine exposure and benefits.
• Negotiates settlements within designated authority.
• Calculates reserves and ensures adequacy throughout the life of the claim.
• Prepares state filings within statutory limits and manages litigation processes.
• Coordinates vendor referrals for investigation or litigation management.
• Uses cost containment techniques including vendor partnerships to reduce claim costs.
• Manages claim recoveries including subrogation and offsets.

Skills

Communication

Analytical skills

Organizational skills

Interpersonal skills

Negotiation

Teamwork

Service orientation

Education

Bachelor's degree

Job description

Sedgwick is seeking a Claims Examiner- Workers' Compensation to analyze complex claims, determine benefits, and manage high-exposure cases through adjudication and rehabilitation.

The role requires a Bachelor's degree and at least five years in claims management, with strong negotiation, analytical, and communication skills. You will work with clients, vendors, and internal teams to ensure timely resolutions and cost-effective outcomes.