Claims Adjuster – Workers Compensation

This is a fully remote position, open to applicants in New York.

📋 Description

• Evaluate mid- and upper-level workers compensation claims to ascertain benefits owed

• Maintain the ongoing adjudication of claims in accordance with company standards and industry best practices

• Identify claim subrogation opportunities and negotiate settlements

• Analyze and manage claims through action plans for timely resolution

• Investigate and collect information to assess claim exposure

• Negotiate claim settlements within assigned authority limits

• Communicate claim progress and processing details with claimants and clients

• Report claims to the excess carrier and address requests for guidance

• Utilize Sedgwick's global network of experts to gain and share insights

• Provide customer-facing solutions to clients across various industries

⛳️ Requirements

• High School Diploma or GED is mandatory

• A Bachelor's degree from an accredited institution is preferred

• Relevant professional certification related to the line of business is preferred

• Minimum of 4 years of claims management experience or a similar combination of education and experience is required

• Competence in analyzing and processing workers compensation claims

• Ability to investigate and gather pertinent information to evaluate claim exposure

• Proficiency in negotiating claim settlements within designated authority

• Skill in communicating claim activity and processing updates with claimants and clients

• Capability to report claims to excess carriers and respond to guidance requests

• Strong clear and conceptual thinking abilities

• Excellent judgment, troubleshooting, problem-solving, analytical skills, and discretion

• Capacity to manage work-related stress and multiple priorities simultaneously

• Ability to meet deadlines

• Proficient in computer keyboarding

• Adequate hearing, vision, and verbal communication skills

🏝️ Benefits

• Flexible work schedule

• Referral incentive program

• Opportunity to work in an agile environment

• Career development and promotional growth opportunities

• Medical, dental, vision, and 401K benefits available from day one

• 401k matching

• Paid Time Off (PTO)

• Disability and life insurance

• Employee assistance program

• Flexible spending or health savings account options

• Additional voluntary benefits available

• Flexible work location, autonomy in daily tasks, and defined career paths

• Opportunities for professional development