Workers Compensation Claims Examiner – CT, MA, NJ, VT Jurisdiction Experience

This is a fully remote position, open to applicants in Connecticut, +4 more states.

📋 Description

• Assess lost-time Workers Compensation claims for clients to identify entitled benefits.

• Maintain the ongoing adjudication of claims in alignment with service expectations, industry standards, and client requirements.

• Analyze and process claims through action plans to achieve timely resolutions.

• Investigate and collect information to evaluate claim exposure.

• Negotiate claim settlements within the authorized limits.

• Communicate updates on claim activity and processing to claimants and clients.

• Report claims to excess carriers as necessary.

• Address requests for guidance in a professional and timely manner.

• Utilize Sedgwick's global network of experts to acquire and share valuable insights.

• Engage in professional development opportunities to enhance skills.

⛳️ Requirements

• High School Diploma or GED is mandatory.

• Bachelor’s degree from an accredited institution is preferred.

• Professional certification relevant to the line of business is preferred.

• A minimum of 3 years of claims management experience or a suitable combination of education and experience is required.

• Experience in handling lost-time Workers Compensation claims is necessary.

• Knowledge of jurisdictional regulations in CT, MA, NJ, and VT.

• Possession of VT and CT licenses is required.

• Proficiency in analyzing and processing claims.

• Capability to investigate and compile information to ascertain claim exposure.

• Skill in negotiating claim settlements within given authority.

• Ability to communicate effectively regarding claim activity and processing with claimants and clients.

• Competence in reporting claims to excess carriers and addressing direction requests.

• Strong analytical and conceptual thinking skills.

• Excellent judgment, troubleshooting, problem-solving, and discretion abilities.

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

• Ability to meet deadlines consistently.

• Proficient computer keyboarding skills.

• Adequate hearing, vision, and verbal communication abilities.

🏝️ Benefits

• Flexible work schedule.

• Referral incentive program.

• Opportunities for career development and advancement.

• Medical, dental, and vision insurance coverage.

• 401K enrollment from day one.

• 401K matching program.

• Paid time off (PTO).

• Disability insurance.

• Life insurance.

• Employee assistance program.

• Flexible spending or health savings account options.

• Additional voluntary benefits.

• Reasonable accommodations available.

• Flexible location and career path options.