Claims Examiner Workers Compensation I Remote

About Sedgwick

By joining Sedgwick, you'll be part of something truly meaningful. As the world's leading risk and claims administration partner, we help clients thrive by navigating the unexpected. Our expertise, combined with advanced AI-enabled technology, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall.

With over 33,000 colleagues and 10,000 clients across 80 countries, we provide unmatched perspective and "caring that counts" in a rapidly changing and complex risk landscape. 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. Sedgwick is recognized by Newsweek as one of America's Greatest Workplaces, certified as a Great Place to Work®, and named a Fortune Best Workplace in Financial Services & Insurance.

About the Role

As a Claims Examiner specializing in Workers' Compensation, you will analyze complex and technically difficult claims to determine benefits due and manage high-exposure cases involving litigation and rehabilitation. Your work ensures ongoing adjudication within service expectations, industry best practices, and specific client requirements.

In this role, you will serve as a subject matter expert, investigating claims to determine exposure and managing them through well-developed action plans to timely resolution. You will negotiate settlements, calculate reserves, and manage claim recoveries, including subrogation and offsets. Beyond technical analysis, you will coordinate vendor referrals, utilize cost containment techniques, and maintain professional relationships with claimants and clients. This position offers the opportunity to make a tangible impact on the lives of people facing the unexpected while working in a remote environment.

Hiring Process

We are always accepting applications. If you're excited about this role but your experience doesn't align perfectly with every qualification, consider applying anyway. Sedgwick recognizes that each person possesses a unique combination of skills, knowledge, and experience, and you may be just the right candidate for this or other roles.

Our Culture & Commitment

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. We are building a diverse, equitable, and inclusive workplace and consider qualified applicants regardless of background. When applicable, reasonable accommodations will be considered to support your work environment.