Workers Compensation Claims Examiner | Dedicated Client | Jurisdictions: DE, IL, LA, MO, NJ, OK, TN, TX | Licensing: Required | Litigation Experience

Sedgwick Claims Management Services Ltd; North Carolina; Hybride; USD 70 000 - 75 000; Plein temps

Avantages offerts par ce poste

Flexible work schedule

Referral incentive program

Comprehensive benefits package

Résumé du poste

Sedgwick is seeking a Lost-Time Workers' Compensation Claims Examiner to join its remote US team. You will analyze complex claims, determine benefits, and ensure adjudication aligns with client requirements and service expectations.

Ideal candidates have 5 years of claims management experience, a Bachelor's degree, and knowledge of the listed jurisdictions. Sedgwick offers growth, flexible scheduling, and comprehensive benefits.

Qualifications

• Education: High School Diploma or GED required; Bachelor's degree preferred.
• 5 years of claims management experience or equivalent.
• Professional certification as applicable to line of business preferred.
• Jurisdiction knowledge includes DE, IL, LA, MO, NJ, OK, TN, TX.

Responsabilités

• Analyzing and processing Lost-Time Workers' Compensation claims to determine benefits and exposure.
• Negotiating settlements within designated authority.
• Communicating claim activity with the claimant and the client.
• Reporting claims to the excess carrier and handling directions professionally.

Connaissances

Analytical thinking

Claims management experience

Jurisdiction knowledge

Formation

Bachelor's degree

Professional certification (as applicable)

Description du poste

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve.

Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Workers Compensation Claims Examiner | Dedicated Client | Jurisdictions: DE, IL, LA, MO, NJ, OK, TN, TX | Licensing: Required | Litigation Experience

Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands?

Apply your examiner knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations. Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. Leverage Sedgwick’s broad, global network of experts to both learn from and to share your insights. Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career. Enjoy flexibility and autonomy in your daily work, your location, and your career path. Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

PRIMARY PURPOSE OF THE ROLE

To analyze Lost-Time Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.

ESSENTIAL RESPONSIBLITIES MAY INCLUDE

• 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.

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: 5 years of claims management experience or equivalent combination of education and experience required. Heavy Litigation - experience required Jurisdiction Knowledge: DE, IL, LA, MO, NJ, OK, TN, TX Licensing: Home state plus DE, LA, OK, TX

WORK ENVIRONMENT REQUIREMENTS INCLUDE

• Mental:Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
• Physical:Computer keyboarding
• Auditory/Visual: Hearing, vision and talking

TAKING CARE OF YOU

• Flexible work schedule.
• Referral incentive program.
• Career development and promotional growth opportunities.
• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

For the jurisdiction noted in this job posting only, the range of starting pay for this role is (70-75K).

• A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location.

#claimsexaminer #claims #LI-REMOTE

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge and experience. You may be just the right candidate for this or other roles.

Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company’s expertise, combined with the most advanced AI-enabled technology available…