Senior Workers' Compensation Claims Specialist

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

Job summary

Sedgwick is seeking a Claims Examiner (Worker's Compensation) in Michigan to analyze complex WC claims, determine benefits, and support litigation and rehabilitation efforts. The role requires handling high-exposure cases, subrogation, and settlements within authority limits.

Ideal candidates will have a bachelor's degree with at least five years of claims management experience, strong analytical and negotiation skills, and proficiency in Microsoft Office. Travel may be required.

Qualifications

• Bachelor's degree from an accredited college or university preferred.
• Five (5) years of claims management experience or equivalent combination of education and experience required.
• Subject matter expert of appropriate insurance principles and laws for line-of-business handled.
• Excellent oral and written communication, including presentation skills.

Responsibilities

• Analyzes and processes complex workers' compensation claims by investigating and gathering information to determine exposure.
• Negotiates settlements within designated authority.
• Calculates and assigns reserves to claims; manages reserve adequacy throughout the life of the claim.
• Calculates and pays benefits due; approves and makes timely claim payments and adjustments.
• Prepares state filings within statutory limits.
• Manages the litigation process and costs.
• Coordinates vendor referrals for investigation or litigation management.
• Drives subrogation and cost containment efforts for clients.
• Communicates claim activity with claimants and clients; maintains professional relationships.

Skills

Claims management

Analytical skills

Negotiation

Communication

Teamwork

Microsoft Office

Education

Bachelor's degree

Professional certification

Tools

Microsoft Office

Job description

Sedgwick is seeking a Claims Examiner (Worker's Compensation) in Michigan to analyze complex WC claims, determine benefits, and support litigation and rehabilitation efforts. The role requires handling high-exposure cases, subrogation, and settlements within authority limits.

Ideal candidates will have a bachelor's degree with at least five years of claims management experience, strong analytical and negotiation skills, and proficiency in Microsoft Office. Travel may be required.