Workers Compensation Claims Examiner

Sedgwick

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

Posted 10/23/2026full-timeSyracuse • New York • United StatesJuniorMid-Level💰 $70,000 - $80,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in analyzing and processing Lost-Time Workers Compensation claims, ensuring timely resolution and adherence to industry best practices. Proficient in negotiating settlements and communicating effectively with claimants and clients while managing multiple priorities under pressure.

Highest-signal resume keywords

Claims Management ExperienceNegotiation SkillsAdjudication of Customer ClaimsJurisdiction Knowledge: NYProfessional Certification

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims AnalysisClaims ProcessingSettlement NegotiationAdjudicationComputer Keyboarding

Soft Skills

Clear Thinking AbilityExcellent JudgmentProblem SolvingDiscretionAbility to Handle Work-Related Stress

Certifications & Qualifications

Professional CertificationNY Licensing

Industry Keywords

Lost-Time Workers CompensationClaim ExposureService ExpectationsClient RequirementsBest Practices

About the role

Key responsibilities & impact

Analyze and process Lost-Time 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 direction professionally and promptly
Adjudicate complex customer claims and determine benefits due
Ensure ongoing claim adjudication meets service expectations, industry best practices, and client requirements

Requirements

What you’ll need

2 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: NY
NY licensing preferred, not 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
Hearing, vision, and talking

Benefits

Comp & perks

Flexible work schedule
Referral incentive program
Career development and promotional growth opportunities
Medical, dental, and vision benefits on day one
401K on day one
401K matching
PTO
Disability and life insurance
Employee assistance
Flexible spending or health savings account
Other additional voluntary benefits
Remote work flexibility outside commutable distance to Syracuse, NY
Hybrid schedule within commutable distance to Syracuse, NY