Workers Compensation Claims Examiner | Jurisdiction Experience: NY | Licensing Required: NY
About The Position
The Workers Compensation Claims Examiner analyzes New York lost-time claims for clients to determine benefits due. The role requires ongoing claim adjudication within service expectations, industry best practices, and client-specific requirements. The examiner investigates and gathers information to assess claim exposure, develops and processes 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 direction requests professionally and promptly. The position is based in Syracuse, New York, with a hybrid arrangement for employees within commuting distance of the office and remote work for those outside commuting distance. New York jurisdiction knowledge and licensing are required. Sedgwick describes a flexible, agile work environment with career development and growth opportunities, along with comprehensive benefits.
Requirements
- High school diploma or GED required.
- At least two years of claims management experience, or an equivalent combination of education and experience, required.
- New York jurisdiction knowledge required.
- New York licensing required.
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 action plans to reach appropriate and timely resolutions.
- Investigate 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 to requests for direction professionally and in a timely manner.
- Adjudicate New York lost-time claims and determine benefits due while meeting service expectations, industry best practices, and client-specific requirements.
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 account or health savings account.
- Additional voluntary benefits.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
