Workers Compensation Claims Examiner | NY Jurisdiction & Subrogation Experience & NY Licensing [...]

Sedgwick Claims Management Services Ltd; City of Syracuse (NY); On-site; USD 80,000 - 90,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development opportunities

Comprehensive medical benefits

Job summary

Sedgwick Claims Management Services Ltd is seeking a Workers Compensation Claims Examiner in Syracuse, NY. In this role, you will adjudicate lost-time claims, determine benefits due, and ensure compliance with best practices. A minimum of 5 years claims management experience and a NY license are required.

This position offers a flexible work schedule, career growth opportunities, and comprehensive benefits including medical, dental, and 401(k) from day one.

Qualifications

• 5 years of claims management experience or equivalent education and experience.
• NY licensing required for claims examination.
• Professional certification related to claims management preferred.

Responsibilities

• Adjudicate complex customer claims and implement action plans.
• Negotiate claims settlements based on authority.
• Communicate effectively with claimants and clients.
• Report claims to the excess carrier when necessary.

Skills

Claims management expertise

Negotiation skills

Analytical skills

Education

High School Diploma or GED

Bachelor’s degree (preferred)

Job description

Workers Compensation Claims Examiner | NY Jurisdiction & Subrogation Experience & NY Licensing Required

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.

As a Workers Compensation Claims Examiner, you will adjudicate complex customer claims and deliver innovative customer-facing solutions to clients across a wide range of industries. You will analyze Lost-Time Workers Compensation claims, determine benefits due, and ensure ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements. Subrogation experience is required. NY licensing is needed.

Essential 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.

Qualifications

• 5 years of claims management experience or equivalent combination of education and experience.
• High School Diploma or GED required. Bachelor’s degree from an accredited college or university preferred.
• Professional certification relevant to the line of business preferred.
• NY licensing required.

Benefits

• Flexible work schedule.
• Referral incentive program.
• Career development and promotional growth opportunities.
• Medical, dental, vision, 401(k) on day one.
• PTO, disability, life insurance, employee assistance, flexible spending or health savings account, and additional voluntary benefits.

For the jurisdiction noted in this job posting, the starting pay range is $80,000 to $90,000. In addition to a comprehensive benefits package, Sedgwick offers a competitive salary and opportunities for growth.

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

If you’re excited about this role but your experience doesn’t align perfectly with every qualification in the job description, consider applying for it anyway! 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.