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Claims Examiner - Workers Compensation (REMOTE - NY License Required, PA exp highly preferred)

Work from home Full-time role Hiring

About the position By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Claims Examiner - Workers Compensation (REMOTE - NY License Required, PA exp highly preferred) A valid New York Workers’ Compensation Adjuster License is required. Additional experience handling claims in other Northeast states—particularly Pennsylvania—is strongly preferred Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands? Apply your workers compensation knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations. Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. Leverage Sedgwick’s broad, global network of experts to both learn from and to share your insights. Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career. Enjoy flexibility and autonomy in your daily work, your location, and your career path. Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs. ARE YOU AN IDEAL CANDIDATE? To analyze workers compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.

Responsibilities

  • Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
  • Negotiating settlement of claims within designated authority.
  • Communicating claim activity and processing with the claimant and the client.
  • Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

Requirements

  • Five (5) years of claims management experience or equivalent combination of education and experience required.
  • High School Diploma or GED required.
  • A valid New York Workers’ Compensation Adjuster License is required.

Nice-to-haves

  • Bachelor's degree from an accredited college or university preferred.
  • Professional certification as applicable to line of business preferred.
  • Additional experience handling claims in other Northeast states—particularly Pennsylvania—is strongly preferred

Benefits

  • Flexible work schedule.
  • Referral incentive program.
  • Career development and promotional growth opportunities.
  • A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
  • PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

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