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Sedgwick Claims Management Services

Claims management and risk solutions provider

Workers Compensation Claims Examiner - Public Entity

Claims AdjudicationConfirmed live in the last 24 hours
Full-timeRemote in USA

About the Job

Requirements

  • A high school diploma or GED is required.
  • A bachelor's degree from an accredited college or university is preferred.
  • Professional certification, as applicable to the line of business, is preferred.
  • Three to five years of claims management experience or an equivalent combination of education and experience is required.
  • Public entity workers compensation experience is preferred.
  • Knowledge of New York jurisdiction is required; knowledge of New Jersey jurisdiction is preferred.
  • New York licensing is required.
  • The role requires clear and conceptual thinking, judgment, troubleshooting, problem solving, analysis, discretion, handling work-related stress and multiple priorities, and meeting deadlines.
  • The role requires computer keyboarding and the ability to hear, see, and talk.

Responsibilities

  • Analyze lost-time workers compensation claims on behalf of clients to determine benefits due while ensuring ongoing adjudication meets service expectations, industry best practices, and client service requirements.
  • Analyze and process claims through action plans toward timely resolution by investigating and gathering 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 in a professional and timely manner.

About the Company

Sedgwick Claims Management Services

Claims management and risk solutions provider

Sedgwick manages claims and risk for insurers, corporations, and public entities. Its services cover the full claims lifecycle, including clinical case management, networks, and cost-containment programs, plus specialized work like home inspections and property appraisals. The company operates by charging fees for these managed services that coordinate medical care, assess losses, and support timely resolution. Sedgwick differentiates itself through its integrated, end-to-end approach to claims management and its strong emphasis on caring for people, DEI, and client outcomes. Its goal is to help clients resolve claims efficiently, restore property and brands, and reduce costs through targeted resources deployed at the right time to improve outcomes.

Company size
10,001+
Company stage
Growth Equity (Non-Venture Capital)
Total funding
$1.5B
Headquarters
Memphis, TN
Founded
1969

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