Sedgwick is looking for a Claims Examiner - Workers Comp to analyze complex or technically difficult claims. You will determine benefits due and manage high exposure claims involving litigation and rehabilitation, ensuring ongoing adjudication within service expectations and industry best practices.
What You'll Do
- Analyze and process complex or technically difficult workers' compensation claims by investigating and gathering information to determine exposure.
- Manage claims through well-developed action plans to an appropriate and timely resolution.
- Negotiate settlement of claims within designated authority.
- Calculate and assign timely and appropriate reserves to claims; manage reserve adequacy throughout the life of the claim.
- Calculate and pay benefits due; approve and make timely claim payments and adjustments; settle claims within designated authority level.
- Prepare necessary state filings within statutory limits.
- Manage the litigation process to ensure timely and cost-effective claims resolution.
What We're Looking For
- Five (5) years of Workers Compensation claims management experience or equivalent combination of education and experience.
- Must have a license and experience with Florida (FL), Georgia (GA), South Carolina (SC), and North Carolina (NC) claims.
Nice to Have
- Bachelor's degree from an accredited college or university.
Benefits & Compensation
- 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 Mode
This is a remote position.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
