Claims Associate – Workers Compensation

🕒 May 6

🏈 Alabama, Florida, +3 more states – Remote

🏈 Alabama – Remote 🐊 Florida – Remote 🗽 New York – Remote 🌲 North Carolina – Remote 🎸 Tennessee – Remote

💵 $18 - $22 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

📋 Claims Specialist

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 45%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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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 reported lower-level workers compensation claims to determine benefits due • Ensure ongoing adjudication of claims within company standards and industry best practices • Adjust medical-only and minor lost-time workers compensation claims under close supervision • Support claims representatives, examiners, and leads with larger or more complex claims • Process claims, determine compensability and benefits due, monitor reserve accuracy, and file required state-agency documentation • Communicate claim actions and processing with claimants, clients, and appropriate medical contacts • Ensure claim files are properly documented and claims coding is correct • Process routine payments, prescriptions, and status reports for lifetime or defined-period medical claims when needed • Maintain professional client relationships

🎯 Requirements

• High school diploma or GED required • Required licensing: NY Series 17-72 • One (1) year of general office experience or equivalent combination of education and experience required • Claims industry experience preferred • Knowledge of workers compensation claims processing, compensability, benefits, reserves, documentation, coding, payments, prescriptions, and status reports • Ability to analyze claims and determine benefits due • Ability to communicate with claimants, clients, and medical contacts • Ability to manage multiple priorities and meet deadlines • Excellent judgment, troubleshooting, problem solving, analysis, and discretion • Ability to handle work-related stress • Computer keyboarding ability • Hearing, vision, and talking abilities • Travel as required

🏖️ Benefits

• Flexible work schedule • Referral incentive program • Career development and promotional growth opportunities • Medical, dental, and vision insurance • 401(k) and matching • Paid time off (PTO) • Disability and life insurance • Employee assistance program • Flexible spending or health savings account • Other additional voluntary benefits • Remote work flexibility and autonomy in daily work, location, and career path