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Sedgwick

Workers Compensation Claims Examiner

Sedgwick

. Analyze lost-time workers compensation claims on behalf of clients to determine benefits due .

Posted 10/28/2026full-timeRemote • United StatesMid-LevelSenior💰 $80,000 - $90,000 per yearWebsite

Core Competencies

Role fit
Core Competencies

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

Demonstrates expertise in analyzing and processing lost-time workers compensation claims, negotiating settlements, and communicating effectively with clients and claimants. Possesses strong problem-solving abilities and knowledge of workers compensation jurisdictions.

Highest-signal resume keywords
Claims Management ExperienceWorkers Compensation KnowledgeNegotiation SkillsCommunication SkillsProfessional Certification

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills
Claims AnalysisClaims ProcessingInvestigation SkillsNegotiationReporting ClaimsComputer Keyboarding
Soft Skills
Clear ThinkingExcellent JudgmentProblem-SolvingDiscretionAbility to Handle Stress
Certifications & Qualifications
Professional CertificationLicensing: VT, CT, NH, RI
Industry Keywords
Workers CompensationClaims AdjudicationClient ServiceExcess CarriersService Expectations

About the role

Key responsibilities & impact
  • Analyze lost-time workers compensation claims on behalf of clients to determine benefits due
  • Ensure ongoing adjudication of claims within service expectations, industry best practices, and client service requirements
  • Investigate claims and gather information to determine claim exposure
  • Process claims through action plans toward appropriate and timely resolution
  • Negotiate claim settlements within designated authority
  • Communicate claim activity and processing with claimants and clients
  • Report claims to excess carriers
  • Respond to requests for directions professionally and timely
  • Leverage Sedgwick's global network of experts to learn and share insights
  • Deliver customer-facing solutions to clients across industries

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
  • Knowledge of workers compensation jurisdictions: MA, CT, NH, RI, VT
  • Licensing: VT, CT, NH, RI
  • Ability to analyze and process lost-time workers compensation claims
  • Ability to investigate claims and gather information to determine exposure
  • Ability to negotiate claim settlements within designated authority
  • Ability to communicate claim activity with claimants and clients
  • Ability to report claims to excess carriers and respond to direction requests
  • Clear and conceptual thinking ability
  • Excellent judgment, troubleshooting, problem-solving, analysis, and discretion
  • Ability to handle work-related stress and multiple priorities
  • Ability to meet deadlines
  • Computer keyboarding
  • 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, and vision insurance
  • 401K and matching
  • PTO
  • Disability and life insurance
  • Employee assistance program
  • Flexible spending or health savings account
  • Other additional voluntary benefits
  • Remote work flexibility and autonomy