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Sedgwick

Workers’ Compensation Claims Consultant – Level 2

Sedgwick

. Analyze and process complex or technically challenging workers’ compensation claims by investigating and gathering information to determine claim exposure.

Posted 11/10/2026full-timeRemote • CanadaMid-LevelSenior💰 CA$65,000 - CA$80,000 per yearWebsite

Core Competencies

Role fit
Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in managing complex workers' compensation claims, including negotiation, reserve calculation, and compliance with regulations. Strong analytical, organizational, and communication skills are essential for effective collaboration and timely resolution.

Highest-signal resume keywords
Claims Management ExperienceWorkers' Compensation Legislation KnowledgeNegotiation SkillsAnalytical SkillsParalegal Expertise

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills
Claims ProcessingReserve CalculationCost-Containment TechniquesStatutory FilingsSubrogation ManagementDisability Case ManagementPolicy InterpretationMedical Management PracticesHR Leave ProgramsLitigation Management
Soft Skills
Excellent Communication SkillsStrong Organizational SkillsInterpersonal SkillsTeam CollaborationPresentation Skills
Tools & Technologies
Microsoft Office
Certifications & Qualifications
Professional Certification in Claims Management
Industry Keywords
Workers' Compensation ClaimsHealth and Safety StandardsSocial Security ProceduresMedicare OffsetsClaim SettlementsClaim Exposure AnalysisVendor CoordinationQuality Programs

Tech Stack

Tools & technologies
TypeScript

About the role

Key responsibilities & impact
  • Analyze and process complex or technically challenging workers’ compensation claims by investigating and gathering information to determine claim exposure.
  • Manage claims through action plans to achieve appropriate and timely resolution.
  • Negotiate claim settlements within designated authority limits.
  • Calculate and allocate appropriate reserves in a timely manner and manage their adequacy throughout the life of the claim.
  • Calculate and issue benefits owed; approve and process payments and adjustments; settle claims within authority limits.
  • Prepare required provincial filings within statutory deadlines.
  • Manage the litigation process and ensure prompt, cost-effective resolution.
  • Coordinate vendor recommendations for additional investigations or litigation management.
  • Use cost-containment techniques, including strategic partnerships with vendors.
  • Manage recoveries, including subrogation, Second Injury Fund recoveries, and Social Security and Medicare offsets.
  • Report claims to excess insurers and respond professionally to requests for direction.
  • Communicate claim activity and handling with claimants and clients.
  • Maintain professional relationships with clients.
  • Ensure proper file documentation and accurate coding.
  • Refer files to supervisors and management when necessary.
  • Perform other duties as assigned.
  • Support the organization’s quality programs.
  • Travel as required.

Requirements

What you’ll need
  • Bachelor’s degree from an accredited university or college preferred.
  • Four (4) years of claims management experience, or an equivalent combination of education and experience.
  • Five (5) years of claims management experience, or an equivalent combination of education and experience, required.
  • Working knowledge of applicable regulations, compensation and offsets, disability duration, medical management practices, and Social Security and Medicare claim procedures relevant to the applicable line of business.
  • Strong knowledge of workers’ compensation legislation and health and safety standards.
  • Proven ability to manage complex claims processes and collaborate with stakeholders.
  • Experience with HR leave programs, disability case management, and policy interpretation.
  • Paralegal expertise in handling claims, appeals, and compliance matters.
  • Excellent oral and written communication skills, including presentation skills.
  • Proficiency with computer applications, including Microsoft Office products.
  • Strong analytical and interpretive skills.
  • Strong organizational skills.
  • Good interpersonal skills.
  • Excellent negotiation skills.
  • Ability to work effectively in a team environment.
  • Ability to meet or exceed service expectations.
  • Professional certification applicable to the line of business preferred.
  • Ability to travel as required.

Benefits

Comp & perks
  • Work-life balance
  • Caring culture
  • Inclusive, barrier-free recruitment and selection processes
  • Accommodation available during recruitment and selection, if required