Workers Compensation Examiner – NJ, PA

Sedgwick

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

Posted 10/30/2026full-timeRemote • United StatesMid-LevelSenior💰 $60,000 - $80,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in analyzing and processing Workers Compensation claims, negotiating settlements, and communicating effectively with claimants and clients. Possesses strong problem-solving abilities and knowledge of NJ and PA jurisdictions.

Highest-signal resume keywords

Workers Compensation Claims ManagementClaims InvestigationNegotiation SkillsCustomer CommunicationAnalytical Thinking

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ManagementClaims AnalysisSettlement NegotiationProblem SolvingDeadline Management

Soft Skills

Clear ThinkingExcellent JudgmentDiscretionStress ManagementMultitasking

Tools & Technologies

Sedgwick Global Network

Certifications & Qualifications

Professional Certification (Preferred)

Industry Keywords

NJ JurisdictionPA JurisdictionClaims ProcessingCustomer-Facing Solutions

About the role

Key responsibilities & impact

Analyze and process Workers Compensation claims through action plans to timely resolution
Investigate claims 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 and respond to requests for directions
Adjudicate complex customer claims and deliver customer-facing solutions
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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 NJ and PA jurisdictions
Analyze Workers Compensation claims to determine benefits due
Licensing not required
Ability to investigate and gather claim information
Ability to negotiate settlements within designated authority
Ability to communicate claim activity and processing with claimants and clients
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; hearing, vision and talking

Benefits

Comp & perks

Flexible work schedule
Referral incentive program
Career development and promotional growth opportunities
Medical, dental, vision, 401K and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits
Flexible work arrangements and autonomy in daily work, location, and career path
Professional development opportunities