Workers Compensation Claims Examiner I NY license required I Remote

Lensa; Miami (FL); Remote; USD 56,000 - 80,000; Full time

Job summary

A leading company is seeking a Workers Compensation Claims Examiner I to analyze complex claims and ensure timely adjudication. The role requires expertise in insurance principles, with responsibilities including managing litigation and negotiating settlements. This remote position offers a competitive salary and comprehensive benefits.

Qualifications

• Minimum five years of claims management experience.
• Expertise in insurance principles, law, and claims processes.

Responsibilities

• Investigating and processing complex claims.
• Negotiating settlements within authority limits.
• Managing reserves, benefits payments, and claims adjustments.

Skills

Communication

Negotiation

Organizational Skills

Education

Bachelor's degree

Tools

Microsoft Office

Job description

Workers Compensation Claims Examiner I NY license required I Remote

Join Sedgwick as a Workers Compensation Claims Examiner I, where you'll analyze complex workers' compensation claims, work with high exposure cases involving litigation and rehabilitation, and ensure claims are adjudicated within industry standards and client requirements. This role requires NY licensure and is remote.

Responsibilities include:

• Investigating and processing complex claims, managing them through action plans for timely resolution.
• Negotiating settlements within authority limits.
• Managing reserves, benefits payments, and claims adjustments.
• Preparing state filings, managing litigation, and coordinating investigations.
• Applying cost containment strategies and managing claim recoveries.
• Maintaining professional communication with claimants and clients, ensuring proper documentation.

Qualifications:

• Bachelor's degree preferred; professional certification a plus.
• Minimum five years of claims management experience.
• Expertise in insurance principles, law, and claims processes.
• Strong communication, organizational, negotiation skills, and proficiency in Microsoft Office.

Work Environment:

Includes mental, physical, and auditory/visual demands, with accommodations as needed.

Additional Details:

Salary range: $56,909 - $79,672, with comprehensive benefits. Sedgwick is an Equal Opportunity Employer committed to diversity and inclusion.