Workers' Comp Claims Specialist | Hybrid/Remote Growth

Sedgwick; Lake Forest (CA); Remote; USD 50,000 - 55,000; Full time

Benefits offered by this job

Flexible schedule

Referral program

Agile environment

Career development

Job summary

Sedgwick is seeking an experienced Workers’ Compensation Claims Representative to adjudicate complex claims for clients across various industries. This role involves analyzing lost-time claims, determining benefits due, and ensuring adherence to service expectations and client requirements.

The ideal candidate has 1+ year of claims management experience, educational credentials as noted, and may hold licensing relevant to the line of business.

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: 1+ years of claims management experience or equivalent combination of education and experience required.

Responsibilities

• Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
• Negotiating settlement of claims within designated authority.
• Communicating claim activity and processing with the claimant and the client.
• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

Skills

Claims management experience

Jurisdiction knowledge

Education

High School Diploma or GED

Bachelor's degree

Job description

Sedgwick is seeking an experienced Workers’ Compensation Claims Representative to adjudicate complex claims for clients across various industries. This role involves analyzing lost-time claims, determining benefits due, and ensuring adherence to service expectations and client requirements.

The ideal candidate has 1+ year of claims management experience, educational credentials as noted, and may hold licensing relevant to the line of business.