Claims Adjuster – Workers Compensation

🕒 July 23

🏈 Alabama, Illinois, +5 more states – Remote

🏈 Alabama – Remote 🌽 Illinois – Remote 🌲 North Carolina – Remote 🏈 Ohio – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🤠 Texas – Remote

💵 $60k - $75k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 55%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.Why this score:

• Open for 114 days.
• Jobs at this company usually fill in 21 days.
• Reposted 2 times.

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Sedgwick

WebsiteLinkedInAll Job Openings

10,000+ employees

🏗️ Construction

💼 Consulting

🏥 Healthcare

Construction • Consulting • Healthcare

Sedgwick is a global provider of technology-enabled risk, benefits, and integrated business solutions. They help people and organizations by managing and mitigating risk with solutions in accident, health, disability, unemployment compensation, and liability claims administration, among others. Sedgwick offers services such as claims administration, building consulting, forensic accounting, and forensic engineering. Their specialties include property restoration, brand protection, and loss prevention across several industries, including agriculture, construction, and environmental sectors. The company emphasizes diversity, equity, and inclusion (DEI) as well as environmental, social, and governance (ESG) practices.

📋 Description

• Analyze mid- and higher-level workers compensation claims to determine benefits due • Ensure ongoing adjudication of claims within company standards and industry best practices • Identify subrogation opportunities and negotiate settlements • Manage workers compensation claims, determining compensability and benefits due on long-term indemnity claims • Monitor reserve accuracy and file necessary documentation with state agencies • Develop and manage claims action plans through resolution • Coordinate return-to-work efforts and approve claim payments • Approve and process assigned claims according to claim or client contracts • Communicate claim actions with claimants and clients • Ensure claim files are properly documented and claims coding is correct • Process complex lifetime medical or defined-period medical claims when applicable • Maintain professional client relationships

🎯 Requirements

• Bachelor's degree from an accredited college or university preferred • Professional certification as applicable to line of business preferred • Four (4) years of claims management experience or equivalent combination of education and experience required • Jurisdiction knowledge: MI, TX, IN, IL, OH • Home state licensing required • Ability to analyze complex workers compensation claims • Ability to determine compensability and benefits due • Ability to monitor reserve accuracy and file documentation with state agencies • Ability to develop and manage claims action plans • Ability to coordinate return-to-work efforts and approve claim payments • Ability to manage subrogation claims and negotiate settlements • Ability to maintain accurate claim files and coding • Ability to handle multiple priorities and meet deadlines

🏖️ Benefits

• Flexible work schedule • Referral incentive program • Opportunity to work in an agile environment • Career development and promotional growth opportunities • Medical, dental, and vision insurance • 401K on day one • 401k matching • PTO • Disability and life insurance • Employee assistance • Flexible spending or health savings account • Other additional voluntary benefits

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