Workers Compensation Claims Examiner, NJ & PA, DE Preferred
Sedgwick
Posted: 10/20/2026
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All Care To You
Posted: 10/7/2026Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in analyzing and processing Lost-Time Workers Compensation claims, with a strong ability to negotiate settlements and communicate effectively with clients and claimants. Possesses knowledge of relevant jurisdictions and the ability to manage multiple priorities while maintaining service expectations.
Highest-signal resume keywords
Claims Management ExperienceLost-Time Workers Compensation AnalysisNegotiation of Claim SettlementsKnowledge of New Jersey and Pennsylvania JurisdictionsProfessional Certification in Relevant Line of Business
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 professionally and promptly to requests for direction
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 New Jersey and Pennsylvania jurisdictions
- Delaware licensing preferred
- 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 and processing 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 simultaneously
- Ability to meet deadlines
- Computer keyboarding ability
- Hearing, vision, and talking abilities
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 and life insurance
- Employee assistance program
- Flexible spending account or health savings account
- Other additional voluntary benefits
- Hybrid or remote work flexibility depending on distance from the office
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims AnalysisClaims ProcessingInvestigation of ClaimsNegotiation SkillsReporting to Excess CarriersProblem-SolvingJudgment and DiscretionComputer Keyboarding
Soft Skills
Clear ThinkingExcellent CommunicationAbility to Handle Work-Related StressAbility to Meet Deadlines
Certifications & Qualifications
Professional Certification in Relevant Line of BusinessDelaware Licensing
Industry Keywords
Workers CompensationClaims AdjudicationClient Service RequirementsService ExpectationsClaim Exposure