Claims Representative Jobs

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About The Position

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance. We are seeking a highly motivated and experienced Workers' Compensation Claims Representatives to join our team. The ideal candidate will have at least 2 years of claims handling experience, with a strong background in New York jurisdictional regulations and processes. This position is responsible for managing and processing workers' compensation claims, ensuring timely and accurate decisions while adhering to all applicable laws and regulations. We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

Requirements

  • Minimum of (2) years of workers' compensation claims handling experience.
  • Experience specifically with New York jurisdictional regulations, including knowledge of New York State Workers' Compensation Board rules and procedures.
  • Experience with Public Entity claims management.
  • High school diploma or equivalent; a college degree or relevant certifications (e.g., WCCP, AIC) is a plus.
  • Strong understanding of workers' compensation claims processes, policies, and legal requirements in New York.
  • Excellent written and verbal communication skills.
  • Strong analytical skills with attention to detail and accuracy.
  • Ability to manage multiple claims simultaneously and prioritize workload effectively.
  • Proficiency with claims management software and Microsoft Office Suite (Excel, Word, Outlook).
  • Ability to negotiate settlements and resolve claims disputes effectively.

Responsibilities

  • Independently handle a capped caseload of workers' compensation claims, from inception to resolution, ensuring adherence to company procedures, industry best practices, and regulatory requirements.
  • Ensure compliance with New York workers' compensation laws, including timely filing of reports, adherence to benefit payment timelines, and compliance with statutory requirements.
  • Negotiate settlements of claims within designated authority to reach claim resolution.
  • Provide clear and effective communication with the claimant and client.
  • Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.
  • Maintain accurate and comprehensive records in the claims management system, documenting all actions, decisions, and correspondence related to each claim.

Benefits

  • Flexible work schedule.
  • Referral incentive program.
  • Opportunity to work in an agile or remote environment.
  • Career development and promotional growth opportunities.
  • A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
  • medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

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Common questions about Claims Representative careers and jobs.

Based on current job postings on Teal, the average Claims Representative salary in the US is approximately $65,000 per year, with a typical range of $35,000 to $109,000.
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