Claims Examiner – Workers Compensation

Sedgwick

. Process low-level workers compensation claims to determine compensability and benefits due .

Posted 9/15/2026full-timeAnchorage • Alaska • United StatesMid-LevelSenior💰 $75,000 - $90,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in processing workers compensation claims, ensuring compliance with state regulations, and maintaining accurate documentation. Proven ability to develop claims action plans, negotiate settlements, and communicate effectively with clients and claimants.

Highest-signal resume keywords

Claims Management ExperienceWorkers Compensation Claims ProcessingSubrogation NegotiationJurisdiction Knowledge: AKProfessional Certification

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims AdjudicationReserve MonitoringClaims Action Plan DevelopmentClaims Payment ApprovalClaims Coding AccuracyState Filings CompletionUtilization Review Decision Making

Soft Skills

CommunicationProblem SolvingTime Management

Tools & Technologies

Claims Management Software

Certifications & Qualifications

Professional CertificationAK Licensing

Industry Keywords

Workers CompensationClaims ProcessingSubrogationDocumentation StandardsClient Relationship Management

About the role

Key responsibilities & impact

Process low-level workers compensation claims to determine compensability and benefits due
Ensure ongoing adjudication of claims according to company standards and industry best practices
Monitor reserve accuracy and file required documentation with state agencies
Develop and coordinate claims action plans through resolution and return-to-work efforts
Approve claim payments and administer action plans according to claim or client contracts
Identify subrogation claims and negotiate settlements
Communicate claim actions with claimants and clients
Ensure claim files are properly documented and claims coding is correct
Process low-level lifetime medical and/or defined-period medical claims when applicable
Complete state and physician filings and make decisions on treatments recommended by utilization review
Maintain professional client relationships

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
Jurisdiction knowledge: AK
AK licensing required
Ability to process workers compensation claims and determine compensability and benefits
Ability to monitor reserve accuracy and file documentation with state agencies
Ability to develop and coordinate claims action plans through resolution
Ability to approve and process claims and payments
Ability to administer subrogation and negotiate settlements
Ability to communicate claim actions with claimants and clients
Ability to maintain accurate claim files and coding
Ability to handle multiple priorities, meet deadlines, troubleshoot, problem solve, analyze, and exercise discretion
Computer keyboarding ability
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
401(k) and matching
Paid time off (PTO)
Disability and life insurance
Employee assistance program
Flexible spending or health savings account
Other additional voluntary benefits