Workers Compensation Claims Examiner | Jurisdictions: MA CT RI NH PA NJ | License: CT RI NH | Dedicated Client & Capped Caseloads

Sedgwick•Telecommuter MA, MA

7d•$75,000 - $80,000•Remote

About The Position

Sedgwick is seeking a Workers Compensation Claims Examiner to analyze claims for clients and determine benefits due. The role involves ongoing claim adjudication in accordance with service expectations, industry best practices, and client-specific requirements. The examiner investigates and gathers information to assess claim exposure, develops action plans toward timely resolution, negotiates settlements within designated authority, communicates claim activity to claimants and clients, and reports claims to excess carriers while responding to requests for direction. The listed jurisdictions are MA, CT, RI, NH, PA, and NJ; Vermont jurisdiction knowledge is a plus. Required licensing is CT, RI, NH, or reciprocal, with Vermont licensing a plus. Sedgwick describes a caring culture, flexibility and autonomy, professional development and promotional growth opportunities, and a comprehensive benefits offering. The position requires clear and conceptual thinking, sound judgment, problem-solving and analytical ability, discretion, handling work-related stress and multiple priorities, and meeting deadlines. Physical requirements include computer keyboarding; auditory and visual requirements include hearing, vision, and talking.

Requirements

High school diploma or GED.
At least 3 years of claims management experience, or an equivalent combination of education and experience.
Knowledge of MA, CT, RI, NH, PA, and NJ jurisdictions.
CT, RI, NH, or reciprocal licensing.
Ability to think clearly and conceptually and exercise excellent judgment, troubleshooting, problem-solving, analysis, and discretion.
Ability to handle work-related stress and multiple priorities and meet deadlines.
Computer keyboarding ability.
Hearing, vision, and talking ability.

Nice To Haves

Bachelor's degree from an accredited college or university.
Professional certification applicable to the line of business.
Vermont jurisdiction knowledge.
Vermont licensing.

Responsibilities

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