Workers Compensation Claims Examiner | NY Jurisdiction | NY Licensing Preferred

Workers Compensation Claims Examiner | NY Jurisdiction | NY Licensing Preferred

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

Candidates within commutable distance to a Sedgwick office will be required to work a hybrid schedule.

Job Description

We are seeking a highly motivated and experienced Workers' Compensation Claims Adjuster / Examiner to join our team. The ideal candidate will have at least 2 years of 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.

Qualifications

Experience :

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.

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.