Workers' Compensation Claims Adjuster

Sedgwick

Workers' Compensation Claims Adjuster analyzing Medical Only & Lost-Times Workers Compensation claims for a global leader in risk and claims administration. Ensure ongoing adjudication of claims within client service requirements and industry best practices.

Posted 6/2/2026full-timeRemote • Maryland, New Jersey, New York, Rhode Island, Virginia, West Virginia • 🇺🇸 United StatesMid-LevelSenior💰 $60,000 - $70,000 per yearWebsite

About the role

Key responsibilities & impact

To analyze Medical Only & Lost-Times Workers Compensation claims on behalf of our valued clients to determine benefits due.
Ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution.
Investigating and gathering information to determine the exposure on the claim.
Negotiating settlement of claims within designated authority.
Communicating claim activity and processing with the claimant and the client.
Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

Requirements

What you’ll need

3 - 5 years of claims management experience or equivalent combination of education and experience required.
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.
Jurisdiction Knowledge: NY, VT, & ME (will train on other states)
NY & VT licensing preferred; not required

Benefits

Comp & perks

Flexible work schedule.
Referral incentive program.
Career development and promotional growth opportunities.
A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

claims managementadjudicationnegotiationclaims analysisclaims processinginvestigationreporting

Soft Skills

communicationproblem-solvingorganizational skillsinterpersonal skills

Certifications

Professional certification