Claims Examiner - Workers Compensation

Posted Yesterday
Be an Early Applicant
2 Locations
In-Office
Senior level
Insurance
Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions.
The Role
Analyze and adjudicate workers' compensation claims by investigating facts, determining benefits due, negotiating settlements within authority, communicating with claimants, clients, and carriers, and reporting/responding to excess carrier requests while meeting service expectations.
Summary Generated by Built In

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve.

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

Claims Examiner - Workers Compensation

Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands?   

  • Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.  

​ 

ARE YOU AN IDEAL CANDIDATE? We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.  

PRIMARY PURPOSE OF THE ROLE To analyze Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements. 

ESSENTIAL RESPONSIBLITIES MAY INCLUDE

  • Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the 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 

Education & Licensing: High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. 

Experience: 5 years of claims management experience or equivalent combination of education and experience required. 

TAKING CARE OF YOU  

  • Flexible work schedule.  

  • Referral incentive program.  

  • Career development and promotional growth opportunities.  

  • A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one. 

WORK ENVIRONMENT REQUIREMENTS INCLUDE  
When applicable and appropriate, consideration will be given to reasonable accommodations. 

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, travel as required 

Auditory/Visual: Hearing, vision and talking 

#claimsexaminer #claims #hybrid #LI-REMOTE #Texas #Texasjobs

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

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Skills Required

  • High School Diploma or GED
  • Bachelor's degree from an accredited college or university
  • Professional certification as applicable to line of business
  • 5 years of claims management experience or equivalent combination of education and experience

Sedgwick Compensation & Benefits Highlights

The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Sedgwick and has not been reviewed or approved by Sedgwick.

  • Leave & Time Off Breadth Generous paid time off and paid holidays are emphasized, with PTO accruals increasing with tenure. Paid parental leave and caregiver support further expand time-off coverage.
  • Healthcare Strength Medical, dental and vision coverage is complemented by telemedicine and a personal health concierge. Wellbeing supports such as diabetes and weight-management programs, fertility services, and robust mental-health access (coaching, therapy, psychiatry) broaden care.
  • Parental & Family Support Paid parental leave and caregiver support are offered alongside family-forming resources. Fertility services and adoption assistance reinforce family-oriented benefits.

Sedgwick Insights

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The Company
HQ: Memphis, TN
31,000 Employees
Year Founded: 1969

What We Do

From our modest beginnings as a regional claims administrator, Sedgwick has grown into a leading global provider of technology-enabled risk, benefits and integrated business solutions with 31,000+ colleagues, located across 80 countries. Through innovative product development, organic business development and strategic acquisitions, Sedgwick’s offerings continue to evolve beyond claims processing to meet the current and future needs of our clients. Our approach to delivering quality service in areas such as workers’ compensation, liability, property, disability and absence management goes far beyond just managing claims—we aim to simplify the process and reduce complexity, making it easy and effective for everyone involve.

Why Work With Us

We stay tuned into what our colleagues want and need and deliver a world-class colleague experience that demonstrates how much we value their unique contributions to our business. You’ll see and feel what it’s like to work for a company that’s committed to doing the right thing – for those we serve, for our planet and for each other.

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