Claims Examiner – Workers Compensation, OR Cert Preferred
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Job Description
Remote workers compensation claims examiner adjudicating complex Oregon claims for Sedgwick. Investigating exposures, negotiating settlements, and communicating claim activity with clients and claimants.
Responsibilities:
- Analyze 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
- Analyze and process claims through action plans to timely resolution
- Investigate and gather information to determine claim exposure
- Negotiate settlement of claims within designated authority
- Communicate claim activity and processing with claimants and clients
- Report claims to the excess carrier and respond to requests for directions professionally and timely
Requirements:
- 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
- Licensing/jurisdiction knowledge: OR
- 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
- Travel as required
Benefits:
- Flexible work schedule
- Referral incentive program
- Opportunity to work in an agile environment
- Career development and promotional growth opportunities
- Medical, dental, vision, and 401K on day one
- Remote work flexibility and autonomy in daily work, location, and career path
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