Workers Compensation Claims Examiner – CT, RI, NH

Sedgwick

. Analyze Workers Compensation claims on behalf of valued clients to determine benefits due .

Posted 11/2/2026full-timeRemote • United StatesMid-LevelSenior💰 $75,000 - $80,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Workers Compensation claims management, including analysis, negotiation, and resolution within various jurisdictions. Proficient in maintaining client communication and adhering to service expectations while managing multiple priorities effectively.

Highest-signal resume keywords

Claims Management ExperienceWorkers Compensation AnalysisNegotiation SkillsKnowledge of JurisdictionsProfessional Certification

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims AnalysisClaims ProcessingSettlement NegotiationAdjudicationInformation Gathering

Soft Skills

Clear ThinkingExcellent JudgmentProblem SolvingDiscretionStress Management

Tools & Technologies

Computer Keyboarding

Certifications & Qualifications

Professional CertificationCT LicenseRI LicenseNH LicenseVT License

Industry Keywords

Workers CompensationClaims AdjudicationClient Service RequirementsJurisdiction KnowledgeExcess Carrier Reporting

About the role

Key responsibilities & impact

Analyze Workers Compensation claims on behalf of valued clients to determine benefits due
Ensure ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements
Analyze and process claims through action plans to timely resolution
Investigate and gather information to determine claim 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 timely

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
3+ years of claims management experience or equivalent combination of education and experience required
Knowledge of MA, CT, RI, NH, PA, and NJ jurisdictions
CT, RI, NH, or reciprocal license required
VT jurisdiction knowledge is a plus
VT license is a plus
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
401(k) and matching
Paid time off (PTO)
Disability and life insurance
Employee assistance program
Flexible spending account or health savings account
Other additional voluntary benefits
Flexible work location and autonomy in daily work