Sedgwick · 20 hours ago
Workers' Compensation Claims Adjuster
United States
Full-time
Remote
Mid Level
$65K/yr - $75K/yr
4+ years expSedgwick is a leading company recognized for its exceptional workplace culture and commitment to employee growth. The Workers' Compensation Claims Adjuster role involves analyzing mid- and higher-level claims to determine benefits, ensuring compliance with company standards, and negotiating settlements. The position requires managing claims action plans, communicating with clients, and maintaining professional relationships.
BankingProperty & Casualty InsuranceInsuranceRisk Management
Responsibilities
Manages workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency
Develops and manages workers compensation claims' action plans to resolution, coordinates return-to-work efforts, and approves claim payments
Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract
Manages subrogation of claims and negotiates settlements
Communicates claim action with claimant and client
Ensures claim files are properly documented and claims coding is correct
May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review
Maintains professional client relationships
Performs other duties as assigned
Supports the organization's quality program(s)
Travels as required
Qualification
Required
Bachelor's degree from an accredited college or university preferred
Four (4) years of claims management experience or equivalent combination of education and experience required
Working knowledge of regulations, offsets and deductions, disability duration, medical management practices and Social Security and Medicare application procedure as applicable to line of business
Excellent oral and written communication, including presentation skills
PC literate, including Microsoft Office products
Analytical and interpretive skills
Strong organizational skill
Good interpersonal skills
Excellent negotiation skills
Ability to work in a team environment
Ability to meet or exceed Service Expectations
Preferred
Licensed and Experienced in the following jurisdictions highly preferred: TX. and LA
Benefits
Medical
Dental
Vision
401k and matching
PTO
Disability and life insurance
Employee assistance
Flexible spending or health savings account
Other additional voluntary benefits
Company
Sedgwick
Sedgwick is the world’s leading risk and claims administration partner, helping clients thrive by navigating the unexpected.
10001+ employees
Funding
Current Stage
Late StageTotal Funding
$1.5BKey Investors
Altas PartnersLa Caisse
2024-09-12Private Equity· $1B
2018-12-01Private Equity
2018-09-12Acquired
Leadership Team
Michael Arbour
Chairman & Chief Executive Officer
Kalani Reelitz
Global Chief Financial Officer
Recent News
Morningstar.com
2025-11-10
2025-09-04
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