Workers' Compensation Claims Examiner | NY & VT Jurisdictional Knowledge | Remote
Workers' Compensation Claims Examiner
Remote position with NY & VT jurisdiction knowledge, focusing on Medical Only and Lost-Times workers’ compensation claims.
Primary Purpose of the Role
Analyze Medical Only & Lost-Times Workers Compensation claims on behalf of valued clients to determine benefits due while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
Essential Responsibilities
- Analyzing and processing claims through well‑developed action plans to timely resolution by investigating and gathering information to determine 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.
Qualifications
- 3‑5 years of claims management experience or equivalent combination of education and experience.
- High School Diploma or GED required; Bachelor’s degree preferred.
- Professional certification applicable to line of business preferred.
- Knowledge of NY, VT & ME jurisdictions (will train on other states).
- NY & VT licensing preferred, not required.
Benefits & Working Conditions
- Flexible work schedule.
- Referral incentive program.
- Career development and promotional growth opportunities.
- Diverse and comprehensive benefits offering, including medical, dental, vision, 401(k) on day one and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other voluntary benefits.
- Starting pay range (70 - 80k) in the jurisdiction noted in this posting.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
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