Workers Compensation Claims Examiner | Jurisdictions: MA, CT, NH, RI, VT | Licensing: VT, CT, NH, RI
About The Position
Sedgwick is seeking a Workers Compensation Claims Examiner to analyze lost-time workers’ compensation claims for clients and determine benefits due. The role ensures ongoing claim adjudication in accordance with service expectations, industry best practices, and specific client service requirements. The examiner investigates claims, develops action plans, evaluates exposure, negotiates settlements within designated authority, communicates with claimants and clients, and reports claims to excess carriers. The role covers the jurisdictions of MA, CT, NH, RI, and VT, with licensing identified for VT, CT, NH, and RI. Sedgwick describes a caring, collaborative, and inclusive culture, with professional development opportunities, flexibility and autonomy, and access to a global network of experts. The posting identifies remote work and offers a comprehensive benefits package.
Requirements
- High school diploma or GED.
- Five years of claims management experience, or an equivalent combination of education and experience.
- Jurisdiction knowledge covering MA, CT, NH, RI, and VT.
- Licensing for VT, CT, NH, and RI.
- Ability to think clearly and conceptually and exercise judgment, troubleshooting, problem-solving, analytical skills, and discretion.
- Ability to handle work-related stress, manage multiple priorities, and meet deadlines.
- Ability to perform computer keyboarding and meet hearing, vision, and talking requirements.
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 achieve appropriate and timely resolution.
- Investigate claims 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 excess carriers 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) with matching.
- Paid time off (PTO).
- Disability and life insurance.
- Employee assistance.
- Flexible spending or health savings account.
- Additional voluntary benefits.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
High school or GED
