Workers Compensation Claims Examiner

🔥 44 minutes ago

🏖️ New Jersey – Remote

🏖️ New Jersey – Remote

💵 $80k - $85k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

📋 Claims Specialist

🚫👨‍🎓 No degree required

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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 Medical Only and 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 specific client service requirements • Analyze and process claims through action plans to timely resolution • Investigate and gather information to determine claim exposure • Negotiate settlement of claims within designated authority • Communicate claim activity and processing with claimants and clients • Report claims to the excess carrier • Respond to requests for directions professionally and in a timely manner

🎯 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 • 2+ years of claims management experience or equivalent combination of education and experience required • Jurisdiction knowledge: NJ, PA, VA, MA • Clear and conceptual thinking ability • Excellent judgment, troubleshooting, problem solving, analysis, and discretion • Ability to handle work-related stress • Ability to handle 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 benefits • 401K and matching • PTO • Disability and life insurance • Employee assistance • Flexible spending or health savings account • Other additional voluntary benefits • Reasonable accommodations when applicable and appropriate

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