Claims Examiner - Workers Compensation (REMOTE - Southeast state exp preferred)

Sedgwick • Nashville, TN • 2h ago

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.

Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies

Certified as a Great Place to Work®

Fortune Best Workplaces in Financial Services & Insurance

Claims Examiner - Workers Compensation (REMOTE - Southeast state exp preferred)

Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world's best brands?

Apply your knowledge and experience to adjudicate complex customer claims in the @context of an energetic culture.

Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world's most respected organizations.

Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.

Leverage Sedgwick's broad, global network of experts to both learn from and to share your insights.

Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.

Enjoy flexibility and autonomy in your daily work, your location, and your career path.

Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

ARE YOU AN IDEAL CANDIDATE? We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

PRIMARY PURPOSE : To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.

Negotiates settlement of claims within designated authority.

Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.

Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.

Prepares necessary state fillings within statutory limits.

Manages the litigation process; ensures timely and cost effective claims resolution.

Coordinates vendor referrals for additional investigation and/or litigation management.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

Performs other duties as assigned.

Supports the organization's quality program(s).

Travels as required.

QUALIFICATIONS

Education & Licensing

Bachelor's degree from an accredited college or university preferred.

Experience :

Five (5) years of Workers Compensation claims management experience or equivalent combination of education and experience required.

TAKING CARE OF YOU

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.

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

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

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see sedgwick.com

Go to Apply

Accounting Senior

Norstella • Nashville, TN • 1d ago

Finance, Accounting & Banking

Accounting Senior Company: Norstella Location: Remote, United States Date Posted: Sep 15, 2025 Employment Type: Full Time Job ID: R-1459 Description About Norstella At Norstella, our mission is simple: to help our client...

1d ago

Go to Apply

Accounting Clerk

Vanderbilt University Medical Center • Mount Juliet, TN • 1d ago

Finance, Accounting & Banking

Discover Vanderbilt University Medical Center : Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of individuals who come to work each day...

1d ago

Go to Apply

Senior Coordinator, Revenue Cycle Management

Cardinal Health • Nashville, TN • 1d ago

Finance, Accounting & Banking

What Revenue Cycle Management (RCM) contributes to Cardinal Health Practice Operations Management oversees the business and administrative operations of a medical practice. Revenue Cycle Management manages a team focused...

1d ago

Go to Apply

Banking, Capital Markets Strategy - Director

Accenture • Nashville, TN • 2d ago

Finance, Accounting & Banking

Why Accenture Strategy? In the world of strategy today, it is about the future, and in the future, digital technology is disrupting competitive landscapes and creating new opportunities for almost every organization. Thi...

2d ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.