Workers’ Compensation Claims Careers – Assistant, Associate, Representative, Examiner & Team Leads

About the role

Join Sedgwick, a company that supports people facing unexpected challenges worldwide. We offer a caring culture and work-life balance, where you can grow your career.

Responsibilities

• Provide administrative support to claims staff and perform other office tasks depending on the client program.
• Set up new claims, manage documentation, and maintain accurate records.
• Analyze lower-level medical-only workers’ compensation claims to determine benefits due and ensure ongoing adjudication within company standards and industry best practices.
• Review documentation for completeness and accuracy.
• Process low-level workers’ compensation claims to determine benefits due; ensure ongoing adjudication within company standards and industry best practices; identify subrogation opportunities; and negotiate settlements with general supervision.
• Review coverage, assess damages, and determine liability within authority limits.
• Analyze complex or technically difficult workers’ compensation claims to determine benefits due. Handle high-exposure claims involving litigation and rehabilitation.
• Ensure ongoing adjudication within service expectations, industry best practices, and specific client requirements.
• Identify subrogation opportunities and negotiate settlements.
• Conduct in-depth investigations and make coverage determinations.
• Supervise multiple teams of examiners and technical staff. Monitor workloads, provide training, and oversee individual claim activities.
• Offer technical and jurisdictional guidance on claims adjudication.
• Maintain diaries for team claims, including frequent updates on complex or high-exposure cases.

Requirements

• Claims Assistant: Six (6) months of clerical or customer service experience.
• Claims Associate: One (1) year of general office experience.
• Claims Representative: Two (2) years of workers’ compensation claims management experience.
• Claims Examiner: Five (5) years of workers’ compensation claims management experience, including Georgia (GA) licensing.
• Claims Team Lead: Six (6) years of claims experience, including two (2) years in a supervisory role, and Georgia (GA) licensing.

Benefits

• Flexible work schedule
• Referral incentive program
• Career development and advancement opportunities
• Comprehensive benefits package, including medical, dental, vision, and a 401(k) starting on day one

Pay

Details not specified.

Schedule

Details not specified.

Qualifications

• Georgia (GA) licensing required for Claims Examiner and Claims Team Lead positions.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.