Claims Examiner – Workers Compensation

Sedgwick

. Analyze Workers Compensation claims on behalf of clients to determine benefits due .

Posted 10/8/2026full-timeRemote • United StatesMid-LevelSenior💰 $65,000 - $85,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in analyzing and processing Workers Compensation claims, ensuring compliance with industry best practices and client service requirements. Proficient in negotiating settlements and communicating effectively with claimants and clients while managing multiple priorities and deadlines.

Highest-signal resume keywords

Claims Management ExperienceWorkers Compensation Claims AnalysisNegotiation of Claim SettlementsMI or MN LicensingKnowledge of Midwest States Jurisdiction

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims AnalysisClaims ProcessingInvestigation of Claim ExposureSettlement NegotiationReporting to Excess CarrierComputer Keyboarding

Soft Skills

Clear ThinkingExcellent JudgmentProblem SolvingDiscretionAbility to Handle Work-Related Stress

Certifications & Qualifications

Professional Certification in Line of Business

Industry Keywords

Workers CompensationClaims AdjudicationClient Service RequirementsService ExpectationsAction Plans

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 settlement of claims within designated authority
Communicate claim activity and processing with claimants and clients
Report claims to the excess carrier
Respond to requests for directions professionally and promptly

Requirements

What you’ll need

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
5 years of claims management experience or equivalent combination of education and experience required
Knowledge of Midwest states jurisdiction
MI or MN licensing required
Ability to analyze and process workers compensation claims
Ability to investigate and gather information to determine claim exposure
Ability to negotiate claim settlements within designated authority
Ability to communicate claim activity and processing with claimants and clients
Ability to report claims to the excess carrier and respond to requests for directions
Clear and conceptual thinking ability
Excellent judgment, troubleshooting, problem solving, analysis, and discretion
Ability to handle work-related stress and multiple priorities simultaneously
Ability to meet deadlines
Computer keyboarding ability
Ability to travel as required

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 coverage
401K on day one
401k matching
PTO
Disability and life insurance
Employee assistance
Flexible spending or health savings account
Other additional voluntary benefits