Workers Compensation Claims Examiner | Dedicated Client | Jurisdictions: NJ & PA | Licensing: DE Preferred
About The Position
Sedgwick is hiring a Workers Compensation Claims Examiner to analyze lost-time workers’ compensation claims for a dedicated client in New Jersey and Pennsylvania. The examiner determines benefits due and ensures claims are adjudicated in accordance with service expectations, industry best practices, and client-specific requirements. The role may be based in Marlton, New Jersey, with a hybrid schedule for candidates within commuting distance, or remotely for candidates outside that distance. The position involves investigating claims, developing action plans, negotiating settlements within assigned authority, communicating with claimants and clients, and coordinating with excess carriers. Sedgwick describes its culture as caring and offers flexibility, professional development, and a comprehensive benefits package.
Requirements
- High school diploma or GED required.
- Five years of claims management experience, or an equivalent combination of education and experience, required.
- Knowledge of New Jersey and Pennsylvania jurisdictions.
- Ability to think clearly and conceptually and exercise judgment, troubleshooting, problem-solving, analytical skills, and discretion.
- Ability to handle work-related stress, multiple priorities, and deadlines.
- Computer keyboarding ability.
- Hearing, vision, and talking abilities.
Nice To Haves
- Bachelor’s degree from an accredited college or university preferred.
- Professional certification applicable to the line of business preferred.
- Delaware licensing preferred.
Responsibilities
- Analyze and process claims using action plans to reach appropriate and timely resolutions.
- 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 to requests for direction professionally and promptly.
- Adjudicate claims within 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.
- 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
