Workers Compensation Claims Examiner

🔥 1 minute ago

🦌 Connecticut, Maine, +5 more states – Remote

🦌 Connecticut – Remote 🦞 Maine – Remote 🗻 New Hampshire – Remote 🗽 New York – Remote 🍂 Massachusetts – Remote ⚓ Rhode Island – Remote 🍁 Vermont – Remote

💵 $80k - $90k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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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 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 • Investigate claims 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 • Respond to requests for directions professionally and timely • Leverage Sedgwick's global network of experts to learn and share insights • Deliver customer-facing solutions to clients across industries

🎯 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 workers compensation jurisdictions: MA, CT, NH, RI, VT • Licensing: VT, CT, NH, RI • Ability to analyze and process lost-time workers compensation claims • Ability to investigate claims and gather information to determine exposure • Ability to negotiate claim settlements within designated authority • Ability to communicate claim activity 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 • Ability to meet deadlines • Computer keyboarding • Hearing, vision, and talking

🏖️ 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 and matching • PTO • Disability and life insurance • Employee assistance program • Flexible spending or health savings account • Other additional voluntary benefits • Remote work flexibility and autonomy