Sedgwick is looking for a Claims Examiner - Workers Compensation to analyze complex or technically difficult claims and determine benefits due. At Sedgwick, caring counts, and you'll join a team that values empathy, accountability, and collaboration while tackling high exposure claims involving litigation and rehabilitation.
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.
- Support the organization's quality program(s).
- Travel as required.
What We're Looking For
- Five (5) years of Workers Compensation claims management experience.
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, and 401K on day one.
Work Mode
This is a remote position open to candidates with specific experience handling claims in Florida and Tennessee.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
