Workers Compensation - Claims Representative | Jurisdiction: TX, OK, LA | Licensing: TX Required (Hybrid)

Sedgwick; Plano (TX); Hybrid; USD 55,000 - 75,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Agile work environment

Career development and promotional成长

Comprehensive benefits: medical, dent,

401K on day one

Job summary

Sedgwick in Plano, TX, is seeking a Workers’ Compensation - Claims Representative to analyze complex claims for multiple clients. The role combines in-office collaboration with two remote days in a hybrid schedule, emphasizing adherence to service expectations and client requirements.

The ideal candidate will have 2 years of claims management experience, TX licensing, and a bachelor’s-level background. This position offers growth, competitive benefits, and a supportive team culture.

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: 2 years of claims management experience or equivalent combination of education and experience required.
• Licensing: TX Required and OK, LA preferred
• Jurisdiction Knowledge: TX, OK, LA

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 analysis

Negotiation

Client communication

Time management

Education

High school diploma or GED

Bachelor’s degree preferred

Professional certification applicable to LOB

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 Representative | Jurisdiction: TX, OK, LA | Licensing: TX Required (Hybrid)

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 Workers Compensation 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.

ARE YOU AN IDEAL CANDIDATE?

We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

WORK LOCATIONS

3 day in office, 2 days remote in our Plano, TX office.

PRIMARY PURPOSE OF THE ROLE

To analyze 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 Responsibilities 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: 2 years of claims management experience or equivalent combination of education and experience required.

Licensing: TX Required and OK, LA preferred

Jurisdiction Knowledge: TX, OK, LA

TAKING CARE OF YOU

• Flexible work schedule.
• Referral incentive program.
• Opportunity to work in an agile environment.
• 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

#claimsexaminer #claims #hybrid

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