Sedgwick is looking for a Claims Examiner - Workers Compensation to analyze complex and technically difficult claims, manage high-exposure cases involving litigation, and ensure ongoing adjudication aligns with best practices. You'll join a company with a caring culture built on empathy, accountability, and collaboration.
What You'll Do
- Analyze and process complex 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 your designated authority.
- Calculate and assign timely and appropriate reserves to claims and manage reserve adequacy throughout the claim lifecycle.
- Calculate and pay benefits due; approve and make timely claim payments and adjustments.
- Prepare necessary state filings within statutory limits.
- Manage the litigation process to ensure timely and cost-effective claims resolution.
- Identify subrogation opportunities.
- Support the organization's quality programs.
- Travel as required.
What We're Looking For
- Five (5) years of claims management experience.
Nice to Have
- Bachelor's degree from an accredited college or university.
- Experience with Louisiana and Mississippi (LA/MS) workers' compensation claims.
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. Experience with Louisiana and Mississippi jurisdictions is preferred.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
