Claims Examiner - Workers Compensation | Jurisdiction: NY | Licensing: NY

Sedgwick • Syracuse, NY

19h • $63,404 - $85,000 • Hybrid

About The Position

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. We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion. This role is hybrid if located within a 25 mile radius of any Sedgwick Offices. The primary purpose of the role is 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.

Requirements

• High School Diploma or GED required.
• 5 years of claims management experience or equivalent combination of education and experience required.
• NY jurisdiction and NY licensing

Nice To Haves

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

Responsibilities

• Manages complex workers’ compensation claims from initial investigation through final resolution
• Evaluates claim exposure and develops action plans to drive timely, effective outcomes
• Negotiates settlements within authority while ensuring compliance with guidelines
• Establishs and maintains accurate reserves throughout the life of each claim
• Calculates and issues benefit payments, adjustments, and settlements in a timely manner
• Prepares and submits required state filings within statutory deadlines
• Oversees litigation, partnering with vendors to manage strategy and control costs
• Applies cost containment strategies, including use of preferred vendor partnerships
• Handles claim recoveries such as subrogation, Second Injury Fund, and Medicare/SS offsets
• Reports to excess carriers and responds to requests promptly and professionally
• Communicates regularly with claimants and clients to provide updates and maintain strong relationships
• Ensures claim files are well-documented and coded accurately
• Escalates complex or high-risk cases to leadership as appropriate

Benefits

• Flexible work schedule.
• Referral incentive program.
• Opportunity to work in an agile environment.
• Career development and promotional growth opportunities.
• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
• medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

What This Job Offers

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