Workers Compensation Claims Examiner | NY Jurisdiction | Dedicated Client

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive. 

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to Work®
Most Loved Workplace® 
Forbes Best-in-State Employer

We are seeking a highly motivated and experienced Workers' Compensation Claims Examiners to join our team. The ideal candidate will have at least 5 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.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is ($85k-$95k). A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

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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.