Workers Compensation Claims Examiner – CT, MA, NJ, VT Jurisdiction Experience

🔥 14 hours ago

🦌 Connecticut, New Jersey, +3 more states – Remote

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💵 $80k - $90k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

🦅 H1B Visa Sponsor

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👻 Ghost score 0%

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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 lost-time Workers Compensation claims on behalf of clients to determine benefits due • Ensure ongoing adjudication of claims within service expectations, industry best practices, and client service requirements • Analyze and process claims through action plans to timely resolution • Investigate and gather information to determine claim exposure • Negotiate claim settlements within designated authority • Communicate claim activity and processing with claimants and clients • Report claims to excess carriers • Respond to requests for directions professionally and promptly • Leverage Sedgwick's global network of experts to learn and share insights • Participate in professional development opportunities

🎯 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 • 3 years of claims management experience or equivalent combination of education and experience required • Experience with lost-time Workers Compensation claims • CT, MA, NJ, and VT jurisdiction knowledge • VT and CT licensing • Ability to analyze and process claims • Ability to investigate and gather information to determine claim exposure • Ability to negotiate claim settlements within designated authority • Ability to communicate claim activity and processing with claimants and clients • Ability to report claims to excess carriers and respond to direction requests • Clear and conceptual thinking ability • Excellent judgment, troubleshooting, problem solving, analysis, and discretion • Ability to handle work-related stress and multiple priorities simultaneously • Ability to meet deadlines • Computer keyboarding • Hearing, vision, and talking

🏖️ Benefits

• Flexible work schedule • Referral incentive program • Career development and promotional growth opportunities • Medical, dental, and vision coverage • 401K on day one • 401K matching • Paid time off (PTO) • Disability insurance • Life insurance • Employee assistance • Flexible spending or health savings account • Additional voluntary benefits • Reasonable accommodations • Flexible location and career path

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