Claims Examiner - Workers Compensation | Jurisdiction: FL, GA,TN | Licensing: Home State Required (Hybrid)

Sedgwick • Chicago, IL

12d • $70,000 - $85,000 • Hybrid

About The Position

Analyze workers compensation claims on behalf of clients to determine benefits due. Ensure claims are continually adjudicated in accordance with service expectations, industry best practices, and client-specific requirements. The role involves investigating claims, creating action plans, determining exposure, negotiating settlements within delegated authority, communicating with claimants and clients, and reporting claims to excess carriers. The position is described as hybrid and requires a home-state license.

Requirements

• High school diploma or GED.
• Five years of claims management experience, or an equivalent combination of education and experience.
• Home-state license required.
• Jurisdiction knowledge of Florida, Georgia, and Tennessee.

Nice To Haves

• Bachelor's degree from an accredited college or university.
• Professional certification applicable to the line of business.

Responsibilities

• Analyze and process claims through well-developed action plans to reach an appropriate and timely resolution.
• Investigate and gather information to determine claim exposure.
• Negotiate claim settlements within designated authority.
• Communicate claim activity and processing with claimants and clients.
• Report claims to the excess carrier and respond professionally and promptly to requests for direction.

Benefits

• Flexible work schedule.
• Referral incentive program.
• Career development and promotional growth opportunities.
• Medical, dental, and vision coverage.
• 401(k) and matching.
• Paid time off (PTO).
• Disability and life insurance.
• Employee assistance program.
• Flexible spending account or health savings account.
• Additional voluntary benefits.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED