Claims Examiner - Workers Compensation, Licensing Required

Sedgwick

. Analyze and process Workers Compensation claims through action plans to timely resolution .

Posted 10/23/2026full-timeRemote • United StatesMid-LevelSenior💰 $70,000 - $90,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Workers Compensation claims management, including investigation, negotiation, and resolution of claims while adhering to industry best practices and client service requirements. Proficient in handling multiple priorities and meeting deadlines under work-related stress.

Highest-signal resume keywords

Claims Management ExperienceWWCP CertificationOregon Workers’ Compensation Claims Examiner CertificationJurisdiction Knowledge: WA or ORNegotiation Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims AnalysisClaims ProcessingClaim Settlement NegotiationAdjudication of ClaimsComputer Keyboarding

Soft Skills

Clear Thinking AbilityExcellent JudgmentProblem SolvingDiscretionAbility to Handle Work-Related Stress

Certifications & Qualifications

WWCP CertificationOregon Workers’ Compensation Claims Examiner Certification

Industry Keywords

Workers CompensationClaims ManagementClient Service RequirementsService ExpectationsIndustry Best Practices

About the role

Key responsibilities & impact

Analyze and process Workers Compensation 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 the excess carrier
Respond to requests for directions professionally and promptly
Ensure ongoing adjudication of claims within service expectations, industry best practices, and client service requirements

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
WWCP or Oregon Workers’ Compensation Claims Examiner Certification
Jurisdiction knowledge: WA or OR
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
Hearing, vision and talking

Benefits

Comp & perks

Flexible work schedule
Referral incentive program
Opportunity to work in an agile environment
Career development and promotional growth opportunities
Medical, dental, vision, 401K on day one
401k matching
PTO
Disability and life insurance
Employee assistance
Flexible spending or health savings account
Other additional voluntary benefits
Reasonable accommodations when applicable and appropriate