Talent.com
Claims Examiner - Workers Compensation (REMOTE- Southeast State experience)

Claims Examiner - Workers Compensation (REMOTE- Southeast State experience)

SedgwickOklahoma City, OK, US
1 day ago
Job type
  • Full-time
  • Remote
Job description

Claims Examiner - Workers Compensation (REMOTE- Southeast State Experience)

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

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.
  • Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
  • Manages claim recoveries, including but not limited to : subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
  • Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.
  • Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.
  • Ensures claim files are properly documented and claims coding is correct.
  • 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. Professional certification as applicable to line of business preferred.

    Experience : Five (5) years of 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.

    Create a job alert for this search

    Claim Examiner • Oklahoma City, OK, US

    Related jobs
    • Promoted
    Travel CVOR Tech - $1,518 to $1,683 per week in Enid, OK

    Travel CVOR Tech - $1,518 to $1,683 per week in Enid, OK

    AlliedTravelCareersOklahoma City, Oklahoma, US
    Full-time
    AlliedTravelCareers is working with LRS Healthcare to find a qualified CVOR Tech in Enid, Oklahoma, 73701!.Ready to start your next travel adventure? LRS Healthcare offers a full benefits package, ...Show moreLast updated: 24 days ago
    • Promoted
    Travel CT Tech - $2330.32 / Week

    Travel CT Tech - $2330.32 / Week

    FlexCareOklahoma City, OK, US
    Full-time
    FlexCare is seeking an experienced CT Tech for an exciting Travel Allied job in Oklahoma City, OK.Shift : 3x12 hr nights Start Date : 12 / 15 / 2025 Duration : 13 weeks Pay : $2330.Level I Trauma & Tea...Show moreLast updated: 14 days ago
    • Promoted
    Travel CT Tech - $2,278 to $2,546 per week in Oklahoma City, CT

    Travel CT Tech - $2,278 to $2,546 per week in Oklahoma City, CT

    AlliedTravelCareersOklahoma City, CT, US
    Full-time
    AlliedTravelCareers is working with Prime Time Healthcare to find a qualified CT Tech in Oklahoma City, Connecticut!.Now Hiring : Allied Healthcare CT - Oklahoma City, OK. Contact us for Pay Informat...Show moreLast updated: 21 days ago
    • Promoted
    Assurance Senior

    Assurance Senior

    HoganTaylorOklahoma City, OK, United States
    Full-time
    Our firm stands tall on the principles of unity, service, and dynamic, reflecting in everything we do.If you're someone who thrives in a collaborative, client-focused environment and is ready to ta...Show moreLast updated: 30+ days ago
    • Promoted
    Travel LTAC RN in OKLAHOMA CITY, Oklahoma

    Travel LTAC RN in OKLAHOMA CITY, Oklahoma

    Gifted HealthcareYukon, OK, US
    Full-time
    Long Term Acute Care RNs (LTAC RNs) provide quality patient care during the patient assessment, intervention, and evaluation process. LTAC RNs collaborate with all members of a patient's healthc...Show moreLast updated: 30+ days ago
    • Promoted
    Travel High Risk Antepartum RN - $2,343 per week

    Travel High Risk Antepartum RN - $2,343 per week

    Anders GroupNichols Hills, OK, United States
    Full-time
    Anders Group is seeking a travel nurse RN Post Partum for a travel nursing job in Oklahoma City, Oklahoma.Job Description & Requirements Specialty : Post Partum Discipline : RN Start Date : ASAP Durat...Show moreLast updated: 3 days ago
    • Promoted
    Insurance Benefits Specialist- 100% Remote

    Insurance Benefits Specialist- 100% Remote

    Global EliteOklahoma City, OK, US
    Remote
    Full-time
    Insurance Benefits Specialist- 100% Remote.Now is the best time to join full-time remote completely work from home.All benefits representatives start at entry level and move up! Suggested schedule ...Show moreLast updated: 28 days ago
    • Promoted
    Travel CT Tech - $2,055 to $2,279 per week in Oklahoma City, OK

    Travel CT Tech - $2,055 to $2,279 per week in Oklahoma City, OK

    AlliedTravelNetworkOklahoma City, Oklahoma, US
    Full-time
    AlliedTravelNetwork is working with LRS Healthcare to find a qualified CT Tech in Oklahoma City, Oklahoma, 73104!.Ready to start your next travel adventure? LRS Healthcare offers a full benefits pa...Show moreLast updated: 15 days ago
    • Promoted
    Travel CT Tech - $2506 / Week

    Travel CT Tech - $2506 / Week

    Cynet HealthOklahoma City, OK, US
    Full-time
    Cynet Health is seeking an experienced CT Tech for an exciting Travel Allied job in Oklahoma City, OK.Shift : 3x12 hr nights Start Date : 12 / 08 / 2025 Duration : 13 weeks Pay : $2506 / Week.Ranked #5 Bes...Show moreLast updated: 15 days ago
    • Promoted
    Patient Access Specialist I / (Sat / Sun)

    Patient Access Specialist I / (Sat / Sun)

    Oklahoma Heart HospitalOklahoma City, OK, United States
    Part-time
    Join Our Team at Oklahoma Heart Hospital (OHH).At OHH, we believe that patient care is truly at the heart of everything we do. Our dedicated team members are involved in every step of our patients' ...Show moreLast updated: 9 days ago
    • Promoted
    Travel RN - Case Management - Oklahoma City, Oklahoma - $2372 / week

    Travel RN - Case Management - Oklahoma City, Oklahoma - $2372 / week

    Vetted HealthOklahoma City, OK, United States
    Temporary
    Job Opportunity : RN - Case Management.Specialty : RN - Case Management.Location : Oklahoma City, Oklahoma.Coordinates total nursing care for patients. Participates in patient and family teaching.Provi...Show moreLast updated: 3 days ago
    • Promoted
    Travel CT Technologist - $2,542 per week

    Travel CT Technologist - $2,542 per week

    Prime Time HealthcareOklahoma City, OK, United States
    Full-time
    Prime Time Healthcare is seeking a travel CT Technologist for a travel job in Oklahoma City, Oklahoma.Job Description & Requirements. Prime Time Healthcare is a leading provider of traveling healthc...Show moreLast updated: 14 days ago
    • Promoted
    • New!
    Workers Compensation Claims Representative

    Workers Compensation Claims Representative

    Oklahoma StaffingOklahoma City, OK, US
    Full-time
    Workers Compensation Claims Representative.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 ...Show moreLast updated: 1 hour ago
    • Promoted
    Travel Nurse RN - Home Health - $1,783 to $1,932 per week in Oklahoma City, OK

    Travel Nurse RN - Home Health - $1,783 to $1,932 per week in Oklahoma City, OK

    TravelNurseSourceOklahoma City, Oklahoma, United States
    Full-time
    TravelNurseSource is working with Host Healthcare to find a qualified Home Health RN in Oklahoma City, Oklahoma, 73120!.Pay Information $1,783 to $1,932 per week. About The Position Host Healthcare ...Show moreLast updated: 2 days ago
    • Promoted
    Travel CT Tech - $2363 / Week

    Travel CT Tech - $2363 / Week

    Host HealthcareOklahoma City, OK, US
    Full-time
    Host Healthcare is seeking an experienced CT Tech for an exciting Travel Allied job in Oklahoma City, OK.Shift : 12 hr nights Start Date : 12 / 15 / 2025 Duration : 13 weeks Pay : $2363 / Week.At Host Heal...Show moreLast updated: 14 days ago
    • Promoted
    Remote Claims Writer

    Remote Claims Writer

    Metro Public AdjustmentBethany, Oklahoma, United States
    Remote
    Full-time
    Job Description : The position we are hiring for is customer / client relations.In this position you will be writing claims and submitting the paperwork. Duties can be performed remotely.Company Inform...Show moreLast updated: 1 day ago
    • Promoted
    Travel CT Tech - $2,055 to $2,279 per week in Oklahoma City, OK

    Travel CT Tech - $2,055 to $2,279 per week in Oklahoma City, OK

    LRS HealthcareOklahoma City, Oklahoma, US
    Full-time
    Ready to start your next travel adventure? LRS Healthcare offers a full benefits package, 24 / 7 support, and a responsive, traveler-first culture. What are you waiting for? Apply today!.Valid license...Show moreLast updated: 15 days ago
    • Promoted
    Workers' Compensation Claims Adjuster (CONTRACT)

    Workers' Compensation Claims Adjuster (CONTRACT)

    Argonaut Management Services, IncOklahoma City, OK, United States
    Full-time
    Argo Group International Holdings, Inc.American National, US based specialty P&C companies, (together known as BP&C, Inc. Brookfield Wealth Solutions, Ltd.BWS"), a New York and Toronto-listed public...Show moreLast updated: 30+ days ago