Claims Liability Adjuster (Remote)

Full time

Fortune Best Workplaces in Financial Services & Insurance

Claims Adjuster - Workers Compensation | Jurisdiction: Required - Remote

Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands?

Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.

We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

To analyze mid- and higher-level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements.

Manages workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.

Develops and manages workers compensation claims’ action plans to resolution, coordinates return-to-work efforts, and approves claim payments.

Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.

Manages subrogation of claims and negotiates settlements.

Communicates claim action with claimant and client.

Ensures claim files are properly documented and claims coding is correct.

May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.

Bachelor's degree from an accredited college or university preferred. Four (4) years of claims management experience or equivalent combination of education and experience required.

Flexible work schedule.

Opportunity to work in an agile environment.

Career development and promotional growth opportunities.

A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

Computer keyboarding, travel as required

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The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company’s expertise, combined with the most advanced AI-enabled technology available, 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, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape.