Claims Examiner I – Workers Compensation, FL, GA, NC, SC

Sedgwick

. Analyze workers compensation claims on behalf of clients to determine benefits due .

Posted 10/8/2026full-timeRemote • United StatesMid-LevelSenior💰 $60,234 - $85,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in analyzing and managing workers compensation claims, ensuring compliance with industry standards and client requirements. Proficient in negotiating settlements and communicating effectively with claimants and clients.

Highest-signal resume keywords

Claims Management ExperienceNegotiation SkillsKnowledge of FL, GA, NC, and SC Licensing RequirementsProfessional CertificationAnalytical Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims AnalysisClaims ProcessingAdjudicationAction Plan DevelopmentInformation Gathering

Soft Skills

Excellent JudgementDiscretionClear ThinkingDeadline Management

Tools & Technologies

Computer Keyboarding

Certifications & Qualifications

Professional Certification

Industry Keywords

Workers CompensationClaims SettlementClient Service RequirementsExcess Carriers

About the role

Key responsibilities & impact

Analyze workers compensation claims on behalf of clients to determine benefits due
Ensure ongoing adjudication of claims within service expectations, industry best practices, and client service requirements
Analyze and process claims through action plans to timely resolution
Investigate and gather information to determine claim exposure
Negotiate claim settlements within designated authority
Communicate claim activity and processing with claimants and clients
Report claims to excess carriers
Respond professionally and timely to requests for directions

Requirements

What you’ll need

5 years of claims management experience or equivalent combination of education and experience required
High School Diploma or GED required
Bachelor's degree from an accredited college or university preferred
Professional certification as applicable to line of business preferred
Knowledge of FL, GA, NC, and SC licensing/jurisdiction requirements
Computer keyboarding
Hearing, vision, and talking abilities
Clear and conceptual thinking ability
Excellent judgement and discretion
Ability to meet deadlines

Benefits

Comp & perks

Flexible work schedule
Referral incentive program
Opportunity to work in an agile environment
Career development and promotional growth opportunities
Medical, dental, and vision benefits
401(k) and matching
Paid time off (PTO)
Disability and life insurance
Employee assistance
Flexible spending or health savings account
Other additional voluntary benefits
Flexible location and career path
Professional development opportunities