Workers Compensation Claims Examiner | NY Jurisdiction | NY Licensing | Remote

Sedgwick Claims Management Services Ltd; New York (NY); Hybrid; USD 75,000 - 85,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentives

Career development

Job summary

Sedgwick is seeking a Workers Compensation Claims Examiner in NY jurisdiction to adjudicate complex customer claims in a dynamic, remote environment. You will analyze claims, gather information, and determine exposure while maintaining service levels and client expectations.

The role requires 4+ years of claims experience, NY licensing knowledge, and a commitment to professional development within Sedgwick's expansive benefits program. A flexible schedule supports work-life balance.

Qualifications

• 4+ years of claims management experience or equivalent combination of education and experience required.
• High School Diploma or GED required. Bachelor’s degree preferred.
• Professional certification as applicable to line of business preferred.
• Jurisdiction Knowledge: NY Licensing.

Responsibilities

• Analyzing and processing claims to determine exposure and resolution.
• Negotiating settlement of claims within designated authority.
• Communicating claim activity with the claimant and client.
• Reporting claims to the excess carrier and responding to directions professionally.

Skills

Claims management

Negotiation

Communication

Reporting

Education

High School Diploma or GED

Bachelor's degree

Professional certification

Job description

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 | NY Jurisdiction | NY Licensing | Remote 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 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.

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.

To analyze Workers Compensation Lost-Time 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.

QUALIFICATIONS Education & Licensing:

4+ years of claims management experience or equivalent combination of education and experience required. 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. Jurisdiction Knowledge: NY Licensing: NY 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.

WORK ENVIRONMENT REQUIREMENTS INCLUDE

When applicable and appropriate, consideration will be given to reasonable accommodations.

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

For the jurisdiction noted in this job posting only, the range of starting pay for this role is (75,000 -85,000/yr).

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.

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, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see sedgwick.com