Remote Workers' Compensation Claims Adjuster (TX, MN, MI)

About the role

Sedgwick is hiring a remote Claims Adjuster for workers' compensation claims in Texas, Minnesota and Michigan. The role analyzes mid- and higher-level claims to determine benefits due, keeps adjudication within company standards and industry best practice, identifies subrogation and negotiates settlements. Texas licensing or home-state licensing is required.

Key responsibilities

• Analyze long-term indemnity claims, determine compensability and benefits due, monitor reserve accuracy and file documentation with the state agency
• Develop and manage claim action plans, coordinate return-to-work efforts and approve claim payments
• Approve and process assigned claims, manage action plans per claim or client contract
• Manage subrogation of claims and negotiate settlements
• Communicate claim action with claimants and clients, and keep claim files properly documented with correct coding
• May process complex lifetime medical and defined-period medical claims, including state and physician filings and utilization review treatment recommendations
• Maintain professional client relationships

Required profile

• Bachelor's degree from an accredited college or university preferred
• Professional certification applicable to the line of business preferred
• Four years of claims management experience or an equivalent combination of education and experience
• Licensing: Texas or home-state license required
• Clear thinking, judgment, problem-solving and analysis, ability to handle stress and multiple priorities, and computer keyboarding

What we offer

• Flexible work schedule and referral incentive program
• Career development and promotional growth opportunities
• Medical, dental, vision, 401K on day one, PTO, disability and life insurance, and other benefits
• Starting pay range of $60,000 to $85,000 for the listed jurisdiction