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Sedgwick

Claims Examiner – Workers Compensation

Sedgwick

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

Posted 10/26/2026full-timeRemote • United StatesMid-LevelSeniorWebsite

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 timely resolution and adherence to industry best practices. Proficient in negotiation, communication, and problem-solving within a claims management context.

Highest-signal resume keywords
Claims Management ExperienceNegotiation SkillsProblem SolvingCommunication SkillsProfessional Certification

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills
Claims AnalysisAdjudicationAction PlansSettlement NegotiationComputer Keyboarding
Soft Skills
Clear ThinkingExcellent JudgmentDiscretionAbility to Handle StressAbility to Manage Multiple Priorities
Certifications & Qualifications
Professional Certification
Industry Keywords
Workers CompensationClaims ProcessingClient ServiceExcess Carrier Reporting

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 claims and gather information to determine 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
  • 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
  • Ability to meet deadlines
  • Computer keyboarding
  • 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
  • Diverse and comprehensive benefits offering including medical, dental, vision, and 401K on day one
  • Work-life balance
  • Professional development opportunities
  • Flexibility and autonomy in daily work, location, and career path