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Sedgwick · 1 month ago

Claims Examiner - Workers Compensation (REMOTE- Home State License required)

United States

Full-time

Remote

Senior Level

5+ years exp

Sedgwick is a global leader in claims management services, dedicated to providing exceptional support to clients facing unexpected challenges. The Claims Examiner role focuses on analyzing complex workers' compensation claims, ensuring timely resolution and adherence to industry best practices.

BankingInsuranceRisk Management

Responsibilities

Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution

Negotiates settlement of claims within designated authority

Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim

Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level

Prepares necessary state fillings within statutory limits

Manages the litigation process; ensures timely and cost effective claims resolution

Performs other duties as assigned

Supports the organization's quality program(s)

Travels as required