Minimum of (2) years of workers' compensation claims handling experience.
Experience specifically with New York jurisdictional regulations, including knowledge of New York State Workers' Compensation Board rules and procedures.
Experience with Public Entity claims management.
Education:
High school diploma or equivalent; a college degree or relevant certifications (e.g., WCCP, AIC) is a plus.
Skills and Abilities:
Strong understanding of workers' compensation claims processes, policies, and legal requirements in New York.
Excellent written and verbal communication skills.
Strong analytical skills with attention to detail and accuracy.
Ability to manage multiple claims simultaneously and prioritize workload effectively.
Proficiency with claims management software and Microsoft Office Suite (Excel, Word, Outlook).
Ability to negotiate settlements and resolve claims disputes effectively.
TAKING CARE OF YOU
Flexible work schedule.
Capped Case Load.
In-depth training.
Sedgwick funded licensing.
Referral incentive program.
Opportunity to work in an agile or remote environment.
Career development and promotional growth opportunities.
A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
WORK ENVIRONMENT REQUIREMENTS INCLUDE
When applicable and appropriate, consideration will be given to reasonable accommodations.
Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
Physical: Computer keyboarding
Auditory/Visual: Hearing, vision and talking
#claimsexaminer #claims #hybrid #remote
#LI-RK1 #LI-REMOTE
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
Benefits
Health insuranceDental insuranceVision insurance401(k)Paid time offRemote work optionsFlexible schedule
Additional Information
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
Workers Compensation Claims Examiner | NY Jurisdiction | Dedicated Client
We are seeking a highly motivated and experienced Workers' Compensation Claims Examiner to join our team. The ideal candidate will have at least 2 years of New York claims handling experience, with a strong background in New York jurisdictional regulations and processes. This position is responsible for managing and processing workers' compensation claims, ensuring timely and accurate decisions while adhering to all applicable laws and regulations.
We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.
ESSENTIAL RESPONSIBILITIES
Independently handle a capped caseload of workers' compensation claims, from inception to resolution, ensuring adherence to company procedures, industry best practices, and regulatory requirements.
Ensure compliance with New York workers' compensation laws, including timely filing of reports, adherence to benefit payment timelines, and compliance with statutory requirements.
Negotiate settlements of claims within designated authority to reach claim resolution.
Provide clear and effective communication with the claimant and client.
Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.
Maintain accurate and comprehensive records in the claims management system, documenting all actions, decisions, and correspondence related to each claim.
Sedgwick · Telecommuter, NY