Workers Compensation Claims Examiner | Jurisdictions: MA, CT, NH, RI, VT | Licensing: VT, CT, NH, RI
About The Position
The Workers Compensation Claims Examiner analyzes lost-time workers compensation claims on behalf of clients to determine benefits due, while ensuring claims are adjudicated in accordance with service expectations, industry best practices, and client-specific requirements. The role investigates claims, develops action plans, negotiates settlements within designated authority, communicates with claimants and clients, and reports claims to excess carriers. Jurisdictions include MA, CT, NH, RI, and VT; licenses are specified for VT, CT, NH, and RI. The role offers flexibility and autonomy, professional development and career growth opportunities, and a comprehensive benefits package. Sedgwick describes its culture as guided by empathy, accountability, collaboration, growth, and inclusion.
Requirements
- High school diploma or GED required.
- Five years of claims management experience, or an equivalent combination of education and experience, required.
- Jurisdiction knowledge: MA, CT, NH, RI, and VT.
- Licensing: VT, CT, NH, and RI.
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 the excess carrier and respond to requests for directions professionally and promptly.
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 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
