Sedgwick is looking for a Claims Representative specializing in Workers Compensation to join our team in Boise, ID. In this role, you will process low-level claims to determine benefits due, ensuring ongoing adjudication follows company standards and industry best practices. You'll work to identify subrogation opportunities and negotiate settlements, contributing to Sedgwick's caring culture built on empathy, accountability, and growth.

What You'll Do

Process low-level workers compensation claims to determine compensability and benefits due on long-term indemnity claims.
Monitor reserve accuracy and file necessary documentation with the state agency.
Develop and coordinate action plans for low-level claims to drive resolution and support return-to-work efforts.
Approve and process assigned claims, determine benefits due, and administer action plans per the claim or client contract.
Administer subrogation of claims and negotiate settlements.
Communicate claim actions with claimants and clients.
Ensure claim files are properly documented and that claims coding is correct.
May process low-level lifetime medical and/or defined period medical claims, including state and physician filings and decisions on treatments.
Maintain professional client relationships.

What We're Looking For

Two (2) years of claims management experience or an equivalent combination of education and experience, or successful completion of Claims Representative training.

Nice to Have

Bachelor's degree from an accredited college or university.
Active Idaho adjusters license (you will be expected to obtain within 3 months if not already acquired).

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.