Workers Compensation Compliance Specialist

Sedgwick

Workers Compensation Compliance Specialist ensuring regulatory standards compliance and maintaining relationships with state regulators. Collaborating and training on compliance issues in a telecommuting role.

Posted 5/6/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $45,000 - $60,000 per yearWebsite

About the role

Key responsibilities & impact

Creates and maintains relationships with state regulators in order to further company’s reputation and standing with the state(s).
Maintains working knowledge of state regulatory system and keeps abreast of state regulatory fee schedule changes and enhancements.
Identifies, develops, and assists in delivery of colleague training on state system compliance issues and enhancements to current systems regarding medical bill review.
Identifies appropriate bill review system enhancements to improve compliance; requests enhancements as appropriate.
Works with state workers compensation agencies as appropriate.
Provides required reporting on claims, penalty and compliance issues to ensure compliance within the state(s).
Acts as the primary liaison between company and carrier partners on specific issues of penalties within the jurisdiction.
Assists in delivery of focused jurisdictional compliance training.

Requirements

What you’ll need

Bachelor's degree from an accredited college or university preferred.
Four (4) years of related experience or equivalent combination of education and experience required.
Experience in claims management, call center, medical bill review or managed care preferred.
Thorough knowledge of state regulatory compliance standards.
Good knowledge of claim management system.
PC literate, including Microsoft Office products.
Analytical and interpretive skills.
Strong organizational skills.
Excellent interpersonal skills.
Ability to work independently or in a team environment.

Benefits

Comp & perks

Three Medical, and two dental plans to choose from.
Tuition reimbursement eligible.
401K plan that matches 50% on every $ you put in up to the first 6% you save.
4 weeks PTO your first full year.

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

claims managementmedical bill reviewregulatory complianceanalytical skillsinterpretive skillsorganizational skills

Soft Skills

interpersonal skillsindependent workteamwork

Certifications

Bachelor's degree