Claims Examiner – Workers Compensation, Multi State, Licensing: TX/FL or Home State preferred

🔥 18 hours ago

🐊 Florida, Michigan, +1 more states – Remote

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⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

🦅 H1B Visa Sponsor

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👻 Ghost score 10%

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Logo of Sedgwick

Sedgwick

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 complex or technically difficult workers' compensation claims to determine benefits due • Work with high-exposure claims involving litigation and rehabilitation • Ensure ongoing adjudication of claims within service expectations, industry best practices, and client service requirements • Identify subrogation of claims and negotiate settlements • Investigate and gather information to determine claim exposure • Process claims through action plans toward appropriate and timely resolution • Negotiate claim settlements within designated authority • Communicate claim activity and processing with claimants and clients • Report claims to excess carriers and respond to direction requests

🎯 Requirements

• High School Diploma or GED required • Bachelor's degree from an accredited college or university preferred • Professional certification as applicable to line of business preferred • 5 years of claims management experience or equivalent combination of education and experience required • Knowledge of multi-state workers' compensation claims • TX/FL or home-state licensing preferred • Ability to analyze complex or technically difficult workers' compensation claims • Ability to handle work-related stress and multiple priorities simultaneously • Ability to meet deadlines • Computer keyboarding • Travel as required

🏖️ Benefits

• Flexible work schedule • Referral incentive program • Opportunity to work in an agile environment • Career development and promotional growth opportunities • Diverse and comprehensive benefits offering including medical, dental, vision, and 401K on day one • Flexible and autonomous daily work, location, and career path • Professional development opportunities

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