Claims Examiner

4 weeks ago


Lake Mary, Florida, United States Sedgwick Full time
Claims Examiner Job Description

Sedgwick is seeking a skilled Claims Examiner to join our team. As a Claims Examiner, you will be responsible for analyzing complex workers' compensation claims to determine benefits due. You will work with high-exposure claims involving litigation and rehabilitation, ensuring ongoing adjudication within service expectations and industry best practices.

Key Responsibilities:
  • Analyze and process complex workers' compensation claims by investigating and gathering information to determine exposure.
  • Negotiate settlement of claims within designated authority.
  • Calculate and assign timely and appropriate reserves to claims.
  • Prepare necessary state filings within statutory limits.
  • Manage the litigation process to ensure timely and cost-effective claims resolution.
Requirements:
  • Bachelor's degree from an accredited college or university preferred.
  • Five (5) years of claims management experience or equivalent combination of education and experience required.
  • Subject matter expert of insurance principles and laws for workers' compensation claims.
  • Excellent oral and written communication skills, including presentation skills.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. We are committed to diversity, equity, and inclusion in the workplace.


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