Claims Examiner – Workers Compensation, Multi State Jurisdiction – Licensing: CA and FL Required

This is a fully remote position, open to applicants in Florida, +1 more state.

📋 Description

• Evaluate Workers Compensation claims on behalf of clients to ascertain benefits owed

• Ensure the continuous adjudication of claims aligns with service expectations, industry best practices, and client service standards

• Analyze and manage claims through action plans to achieve timely and suitable resolutions

• Conduct investigations on claims and collect information to assess exposure

• Negotiate settlements for claims within assigned authority

• Communicate claim developments and processing details with claimants and clients

• Report claims to the excess carrier

• Address requests for directions in a professional and timely manner

• Manage multiple priorities while adhering to deadlines

⛳️ Requirements

• High School Diploma or GED is mandatory

• Bachelor's degree from an accredited institution is preferred

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

• 5 years of experience in claims management or a comparable combination of education and experience is required

• Florida licensing is required

• California licensing is preferred

• Experience in Workers Compensation claims is necessary

• Capability to analyze, investigate, and gather information for determining claim exposure

• Skill in negotiating claim settlements within assigned authority

• Proficient in communicating claim activity and processing with claimants and clients

• Ability to report claims to excess carriers and respond to direction requests

• Capacity to manage multiple priorities and meet deadlines

• Sedgwick is an Equal Opportunity Employer and maintains a Drug-Free Workplace

🏝️ Benefits

• Flexible work schedule

• Referral incentive program

• Opportunities for career development and advancement

• Medical, dental, and vision insurance

• 401K available from day one

• Reasonable accommodations provided when applicable and appropriate