Workers' Compensation Claims Examiner | Jurisdictions: NJ Experience required

Sedgwick • Marlton, NJ

3d

About The Position

Sedgwick is hiring a Workers' Compensation Claims Examiner to analyze New Jersey lost-time workers' compensation claims on behalf of its clients and determine benefits due. The role ensures claims are adjudicated on an ongoing basis in accordance with service expectations, industry best practices, and specific client service requirements. The examiner investigates claims, evaluates exposure, develops action plans, and works toward appropriate and timely resolution. The position also involves communicating with claimants, clients, and excess carriers, and negotiating settlements within designated authority.

The role is part of Sedgwick, a global claims and risk-management company. Sedgwick describes its culture as caring and emphasizes empathy, accountability, collaboration, growth, and inclusion. It offers flexibility and autonomy, professional development and promotional opportunities, and a comprehensive benefits package.

Requirements

• High school diploma or GED required.
• At least 3 years of claims management experience, or an equivalent combination of education and experience, required.
• Knowledge of the New Jersey jurisdiction.
• Ability to think clearly and conceptually and demonstrate sound judgment, troubleshooting, problem-solving, analysis, and discretion.
• Ability to handle work-related stress and multiple priorities simultaneously and meet deadlines.
• Ability to perform computer keyboarding and the hearing, vision, and talking requirements of the role.

Nice To Haves

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

Responsibilities

• Analyze and process claims using 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 direction professionally and promptly.
• Adjudicate New Jersey lost-time workers' compensation claims and determine benefits due while meeting service expectations, industry best practices, and client requirements.

Benefits

• Flexible work schedule.
• Referral incentive program.
• Opportunity to work in an agile environment.
• Career development and promotional growth opportunities.
• Medical, dental, and vision benefits.
• 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