Workers Compensation Claims Examiner | Jurisdictions: MA CT RI NH PA NJ | License: CT RI NH | Dedicated Client & Capped Caseloads
Sedgwick · CT, US
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About the Role
Analyze Workers Compensation claims on behalf of clients to determine benefits due, ensuring ongoing adjudication within service expectations, industry best practices, and specific client service requirements. Join a global industry leader to solve problems for world-class brands and deliver innovative customer-facing solutions.
Responsibilities
- Analyze and process claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
- Negotiate settlement of claims within designated authority.
- Communicate claim activity and processing with the claimant and the client.
- Report claims to the excess carrier and respond to requests of directions in a professional and timely manner.
Requirements
- 3+ years of claims management experience or equivalent combination of education and experience required.
- Jurisdiction Knowledge: MA CT RI NH PA NJ, (VT is a plus)
- Licensing: CT RI NH or reciprocal (VT is a plus)
- Mental: 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; and ability to meet deadlines.
- Physical: Computer keyboarding.
- Auditory/Visual: Hearing, vision and talking.
Skills
- Claims adjudication
- Customer service
- Problem solving
- Analysis
- Negotiation
- Communication
Location
- MA
- CT
- RI
- NH
- PA
- NJ
Work Type
- Hybrid
- Remote
Experience Level
- 3+ years
Education Level
- High School Diploma or GED required
- Bachelor's degree preferred
- Professional certification preferred
Salary/Compensations
- $75,000 - $80,000
Benefits
- Medical
- Dental
- Vision
- 401K on day one
- Referral incentive program
- Career development and promotional growth opportunities
- 401K matching
- PTO
- Disability and life insurance
- Employee assistance
- Flexible spending or health savings account
- Other additional voluntary benefits
About the Company
- Sedgwick is a global industry leader known for its excellence and customer service.
- 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
Equal Opportunity
- Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
- Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.