Workers’ Compensation Claims Specialist (Hybrid/Remote)

Sedgwick; Erie (Erie County); Hybrid; USD 80,000 - 88,000; Full time

Benefits offered by this job

Flexible schedule

Referral incentive program

Agile environment

Career development and growth

Comprehensive benefits: medical,Dental

Job summary

Sedgwick is a global leader in claims administration and risk solutions. We are seeking a dedicated Claims Examiner to analyze Lost-Time Workers' Compensation claims for our valued clients, determining benefits due while following client service requirements and industry best practices.

You will adjudicate claims with a focus on timely resolutions, negotiating settlements within your authority, and coordinating with claimants and clients across NJ and PA.

Qualifications

• 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.
• 5 years of claims management experience or equivalent combination of education and experience required.
• Jurisdiction knowledge NJ & PA.”
• Licensing: DE Preferred.

Responsibilities

• Analyze and process Lost-Time Workers' Compensation claims to determine benefits due and adjudicate within service expectations.
• Negotiate settlements within designated authority.
• Communicate claim activity with the claimant and client.
• Report claims to the excess carrier and respond to directions professionally and promptly.

Education

High School Diploma or GED

Bachelor's degree (preferred)

Professional certification (line of business)

Job description

Sedgwick is a global leader in claims administration and risk solutions. We are seeking a dedicated Claims Examiner to analyze Lost-Time Workers' Compensation claims for our valued clients, determining benefits due while following client service requirements and industry best practices.

You will adjudicate claims with a focus on timely resolutions, negotiating settlements within your authority, and coordinating with claimants and clients across NJ and PA.