Claims Examiner – Workers Compensation, Southeast States

Sedgwick

. Analyze and process workers compensation claims through action plans to timely and appropriate resolution .

Posted 11/9/2026full-timeRemote • United StatesMid-LevelSenior💰 $65,000 - $81,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in analyzing and processing workers compensation claims, ensuring timely resolution while adhering to industry best practices and client service requirements. Proficient in negotiating settlements and managing multiple priorities effectively under pressure.

Highest-signal resume keywords

Claims Management ExperienceNegotiation SkillsJurisdiction Knowledge: FL, GA, NC, SC, AL, AR, KYProfessional CertificationHigh School Diploma or GED

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims AnalysisClaims ProcessingSettlement NegotiationBenefits DeterminationComputer Keyboarding

Soft Skills

Clear Thinking AbilityExcellent JudgmentProblem SolvingDiscretionAbility to Handle Work-Related Stress

Certifications & Qualifications

Professional CertificationFL or Home State Licensing

Industry Keywords

Workers Compensation ClaimsAdjudicationClient Service RequirementsAction PlansClaim Exposure

About the role

Key responsibilities & impact

Analyze and process workers compensation claims through action plans to timely and appropriate 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
Determine benefits due while ensuring ongoing adjudication 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
FL or home state licensing required
Jurisdiction knowledge: FL, GA, NC, SC, AL, AR, KY
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
Medical, dental, and vision benefits on day one
401(k) on day one
401(k) matching
Paid time off (PTO)
Disability insurance
Life insurance
Employee assistance program
Flexible spending account or health savings account
Other additional voluntary benefits
Remote work flexibility and autonomy in daily work, location, and career path