Claims Examiner - Workers Compensation | Jurisdiction: WA | Licensing: Preferred

Claims Examiner – Workers Compensation Jurisdiction: WA | Licensing: Preferred Responsibilities Analyze and process complex or technically difficult workers’ compensation claims, investigate and gather information to determine the exposure on the claim. Manage claims through well‑developed action plans to an appropriate and timely resolution. Negotiate settlement of claims within designated authority. Calculate and assign timely and appropriate reserves to claims; manage reserve adequacy throughout the life of the claim. Calculate and pay benefits due; approve and make timely claim payments and adjustments; settle claims within designated authority level. Prepare necessary state filings within statutory limits. Manage the litigation process, ensuring timely and cost‑effective claim resolution. Coordinate vendor referrals for additional investigation and/or litigation management. Use cost‑containment techniques, including strategic vendor partnerships, to reduce overall cost of claims for clients. Manage claim recoveries, including sub‑rogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets. Report claims to the excess carrier; respond to requests or direction in a professional and timely manner. Communicate claim activity and processing with the claimant and the client; maintain professional client relationships. Ensure claim files are properly documented and claims coding is correct. Refer cases as appropriate to supervisor and management. Perform other duties as assigned. Support the organization’s quality program(s). Travel as required. Qualifications Education: Bachelor’s degree from an accredited college or university preferred. Professional certification applicable to the line of business preferred. Experience: Five (5) years of claims management experience or an equivalent combination of education and experience required. Licensing: WA. Benefits Flexible work schedule. Referral incentive program. Opportunity to work in an agile environment. Career development and promotional growth opportunities. Diverse and comprehensive benefits offering, including medical, dental, vision, and 401(k) on day one. Work Environment Consideration will be given to reasonable accommodations when applicable. Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work‑related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines. Physical: Computer keyboarding, travel as required. Auditory/Visual: Hearing, vision, and speaking ability. Equal Employment Opportunity Statement Sedgwick is an Equal Opportunity Employer and a Drug‑Free Workplace. #J-18808-Ljbffr Sedgwick