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Compensator worker work from home jobs

- 28 jobs
  • Infectious Disease Physician/ Workers Compensation

    STG International 4.7company rating

    Remote job

    STGi is seeking an Infectious Disease physician to perform medical review work and provide consultation and guidance to the Department of Labor (DOL) for a variety of workers' compensation cases. Each physician will receive work on a case by case basis and will be compensated for their work at an hourly rate for time spent performing the reviews. Estimated hours per month may vary. Work will be performed remotely (outside of DOL facilities) at FOH offices or from the physician's home/office. Physician Requirements: Physicians eligible to perform the work must maintain the following credentials and meet the following requirements specified by DOL and FOH: Current, unrestricted license in any state. American Board of Infectious Disease certification Must have a minimum of two years experience clinical practice. Must have a minimum of 240 hrs. of direct patient care annually Must possess understanding of Federal safety and health regulations, and experience reviewing worker's compensation cases. A broad knowledge of requirements of federal workers compensation is desired. STGi is a workforce solutions company providing comprehensive healthcare delivery, Head Start and management consulting services and human capital solutions help our clients. Our services and solutions help our clients sustain and enhance their operations to better accomplish their mission. Pay:$226/hr STGi is committed to hiring and retaining a diverse workforce. We are proud to be an Equal Opportunity/Affirmative Action Employer, making decisions without regard to race, color, religion, creed, sex, sexual orientation, gender identity, marital status, national origin, age, veteran status, disability, or any other protected class. Medical Corps - 60J, 60L, 61F, 61H, 61N, 61R,62B Medical Specialist Corps - 65B, 65C, 65D Nurse Corps - 66B,66H, 66P Medical Service Corps - 67G, 67J Medical CMF - 68A, 68B, 68E, 68F, 68G, 68J, 68Q, 68R, 68S, 68T, 68W, 68X, 68Y
    $67k-87k yearly est. 60d+ ago
  • Workers' Compensation Attorney

    Vecchione Vecchione Connors & Cano

    Remote job

    Job DescriptionVecchione, Vecchione & Cano, LLP, is looking for a Workers' Compensation Attorney to join our dynamic and growing practice. For new attorneys, there will be in depth, in office training, then will turn into a fully remote position. The Attorney will be required to handle hearings and depositions, as well as complete writing assignments as needed. The ideal candidate is an initiative-taker with good analytical skills and will actively participate in all aspects of Workers' Compensation cases from start to finish and make virtual appearances before the Workers' Compensation Board. Responsibilities: Day-to-day handling of cases and depositions. Dictating and/or drafting correspondences to clients keeping them apprised of hearings and depositions results. Interactions with Witnesses to include telephone conferences. Guiding clients, when necessary, through the Workers' Compensation process. Qualifications: Law degree from a fully accredited law school. An active member in good standing with the New York State Bar Association. **Pending admission to NYS Bar Association is acceptable. Workers' Compensation knowledge and experience in New York a plus. Strong attention to detail. Strong written and verbal skills. Excellent growth and advancement opportunities. Please provide your resume, and if applicable include **writing sample and **transcripts. Compensation: Depends On Experience: **100,000-125,000 - MUST HAVE Prior Work Experience ** **125,000-160,000 - MUST HAVE NY Workers' Compensation Experience**
    $58k-97k yearly est. 16d ago
  • Workers Compensation Partner Attorney - Remote (FL) (270/o)

    Denovo Review 4.5company rating

    Remote job

    This opportunity is tailor-made for an accomplished attorney with extensive experience in workers' compensation defense, demonstrating a proven track record in this specialized area of law. As a partner, you will lead our dedicated team, drive our strategic vision in workers' compensation defense, and maintain the exceptional level of service our clients expect. We are seeking candidates throughout Florida! The Workers' Compensation Defense Partner will play a crucial role in managing, leading, and expanding our firm's workers' compensation defense practice. This position involves overseeing case strategy, litigation, and resolution for our clients, as well as mentoring associates and contributing to the firm's overall growth. The ideal candidate is a self-starter, capable of managing a full caseload remotely while fostering client relationships and pursuing business development opportunities. Qualifications: Must have a minimum of 5 years of practice experience in Workers Compensation Defense. Florida Bar member in good standing Benefits Include: Competitive Salary with Yearly BONUS! Company Paid PPO Health Insurance + Dental & Vision Options Generous Paid Time Off + Floating Holiday and Mental Health Day 401K Retirement with Employer Match Diverse, Equal & Inclusive Work Environment Continued Support & Professional Career Development #Promote
    $63k-79k yearly est. 60d+ ago
  • Workers Compensation Partner - Illinois

    Noor Staffing Group

    Remote job

    Currently seeking a full-time Workers' Compensation Partner. The successful candidates will be a self-motivated independent thinker with exceptional attention to detail, excellent time management, organizational, and communication skills, with the ability to work as a team member in a high-volume fast paced work environment. Experience with workers' compensation matters is required. J.D. and license to practice law in Illinois required. At least 5 years of experience in the areas of workers' compensation required. 100% remote
    $55k-82k yearly est. 60d+ ago
  • Associate Underwriter - Excess Workers Compensation

    EIG Services

    Remote job

    Associate Underwriter - Excess Workers Compensation | 100% Remote (WFH) Opportunity Responsible for underwriting new and renewal Excess Workers Compensation accounts for agents and producers assigned within their territory in compliance with company underwriting, pricing and letters of authority. Essential Duties and Responsibilities Underwrite and retain new and renewal business through solid risk analysis, pricing with adherence to state filings, corporate guidelines, and delegated authority. Compile and document underwriting decisions and make referrals to management when appropriate including rational and recommendations. Basic product line and industry knowledge. Awareness of changes/trends in the local and national markets. Collaborate with Sales Team to develop and maintain strong agency relationships with shared accountability in meeting territory goals. Keep leadership, peers and sales team informed of all issues and meaningful activities. Work with general supervision to meet commitments/deadlines. Act with a customer-first mindset and a sense of urgency. Participate and engage in tactical and strategic business planning with Sales and distribution partners. Provide thorough and pertinent information and guidance to Underwriting Services staff required to process coverage requests in accordance with service guidelines and standards/SLA's Provides professional, timely and courteous communication and service to internal and external customers to resolve issues. Focus on exceptional customer service, collaboration with the Sales team, the development of strong agency relationships. Excess WC Agent Relationships: Demonstrates a high level of responsiveness and focuses on supporting Agent's objectives. Establishes, develops, and maintains successful relationships with Agents. Develop strong personal brand to build and maintain a long-term quality pipeline with Agents. Portfolio Management: Assists leadership in managing a sizable book of business by analyzing the portfolio, identifying areas of opportunity for improved growth, profit and diversification, and executing marketing plans to increase market share by stewardship visitation and collaboration with sales at the various offices. A Specialty Associate Underwriter develops knowledge and independent judgement to determine the eligibility of risks when compared to guidelines of programs available. Examines and evaluates documents such as applications forms, supplemental applications, loss control reports, product brochures and financial reports etc to determine degree of risk and acceptability of application for insurance. Develop expertise including education, on-the-job experience, training, and qualifications that make up the know-how in the specialty space with industries and risk types that are not generally within the insurers normal risk profile. Application of underwriting methodologies to support coverage terms / conditions to profitably take risks that do not fit within our core profile and provide solutions and insight for these niche markets. Responsibility for keeping up to date with trends that will impact risk and eligibility in the program space. Requirements Ability to read and interpret documents such as instructions and procedure manuals. Ability to write routine reports and correspondence. Ability to calculate figures and amounts such as discounts, interest, and percentages. Ability to apply problem solving skills involving variable and standard situations. Excellent communication skills including written, verbal, telephone, and virtual meetings Excellent organizational and time management skills. Excellent negotiation skills. Demonstrated proficiency with Microsoft Office Product Suite. Proficiency with pivot tables in excel Foundational knowledge of accounting and finance Knowledge of basic actuarial concepts Education Associate's degree or equivalent from two-year College or technical school, or six months to three years equivalent business experience, or equivalent combination of education and experience. Work Environment: Remote: This role is a remote (work from home (WFH)) opportunity, and only open to candidates currently located in the United States and able to work without sponsorship. It requires a suitable space that provides a private and quiet workplace. Expected Work Hours: Schedules are set to accommodate the requirements of the position and the needs of the organization and may be adjusted as needed. Travel: May be required to travel to off-site location(s) to attend meetings, as necessary Salary Range: $48,000 - $65,000 and a comprehensive benefits package, please follow the link to our benefits page for details! ********************************************************* About EMPLOYERS As a dynamic, fast-growing provider of workers' compensation insurance and services, we are seeking a goal-oriented individual willing to put their ideas to work! We offer a positive, challenging work environment, combined with an opportunity to build your career as you help us grow our business, in innovative and imaginative ways that are uniquely EMPLOYERS! Headquartered in Nevada, EMPLOYERS attributes its long-standing success to its most valuable resource, our employees across the United States. EMPLOYERS is known for the quality service and expertise we provide to our clients, and the exemplary work environment we provide for our employees. We live and breathe our core values: Integrity, Customer Focus, Collaboration, Initiative, Accountability, Innovation, and Personal Fulfillment. These are the pillars that support how we do business with our clients as well as how we treat each other! At EMPLOYERS, you'll discover an energetic environment that inspires top achievement. As “America's small business insurance specialist”, we have the resources, a solid reputation and an expanding nationwide identity to enrich your work/life and enhance your career. #LI-Remote
    $48k-65k yearly 60d+ ago
  • Business Development Underwriter - Workers' Compensation (Chicagoland)

    Insurance Company of The West

    Remote job

    Are you looking to make an impactful difference in your work, yourself, and your community? Why settle for just a job when you can land a career? At ICW Group, we are hiring team members who are ready to use their skills, curiosity, and drive to be part of our journey as we strive to transform the insurance carrier space. We're proud to be in business for over 50 years, and its change agents like yourself that will help us continue to deliver our mission to create the best insurance experience possible. Headquartered in San Diego with regional offices located throughout the United States, ICW Group has been named for ten consecutive years as a Top 50 performing P&C organization offering the stability of a large, profitable and growing company combined with a focus on all things people. It's our team members who make us an employer of choice and the vibrant company we are today. We strive to make both our internal and external communities better everyday! Learn more about why you want to be here! PURPOSE OF THE JOB The purpose of this job is to establish collaborative relationships with agencies and producers to understand the external marketplace and underwrite within established guidelines. This role will evaluate routine business for risk acceptability, matching price to exposure, loss frequency, and severity for profitability, and rating plans/modifications for renewal retention. This role exists to ensure that the Company's marketing and producer management objectives are met, through the generation and maintenance of a profitable book of business. This is a remote role supporting the Chicagoland territory. Qualified candidates must live within the Chicagoland area to effectively service the region. ESSENTIAL DUTIES AND RESPONSIBILITIES Drives and manages a profitable and growing book of business. Sells, services, and maintains a producer force that can sell and control a profitable and growing book of business. Monitors production and quality of assigned producers. Drives profitable sale of the Company's products including increasing sales of existing products and introducing new products as they are developed. Develops the assigned producer group to improve the quality and quantity of the business we obtain from assigned producers. Keeps alert to industry changes, including WCIRB/NCCI rulings, forms, and coverage changes. Prospects and develops new business. Prospects and prequalifies new producers to determine working relationship. Appoints new quality producers; sets and monitors production expectations with each Agency. Attains a thorough knowledge of the geographic territory assigned with regard to production sources, competitor activity, and economic and demographic idiosyncrasies. Produces marketing research to help identify opportunities for management, product enhancements, new distribution channels, and new geographic markets with growth potential. Utilizes underwriting authority to effectively price Company's products. Accepts or rejects simple to slightly complex risks, evaluating all risk characteristics (operations, financials, management, employees, prior experience, etc.) as compared to the average in its class and price for profit within Company Underwriting guidelines. Delivers superior customer service through collaborative relationships. Provides productions support through producer visitations and by participating in underwriting and production presentations. Provides personal assistance to agents and insureds through regular visits to outside locations such as producer's offices. Maintains communication with customers through the use of Company technology. Communicates decisions and resolve agent/customer concerns promptly. Presents Agency Management solutions to agency principals and ICW management team. Serves as the primary Company contact and representative with existing and prospective producers. SUPERVISORY RESPONSIBILITIES This role does not have supervisory responsibilities. EDUCATION AND EXPERIENCE Bachelor's degree from four-year college or university with a major or emphasis in Business, Accounting, Statistics, or related field or equivalent combination of education and experience. Minimum 1 year of related experience and/or training required. Workers' compensation underwriting in the Property and Casualty insurance market strongly preferred. CERTIFICATES, LICENSES, REGISTRATIONS Current driver's license required. KNOWLEDGE AND SKILLS Demonstrated ability to service the Company's clients and maintain relationships with production sources. Ability to apply fundamental Underwriting concepts, practices, and procedures in area of specialization. Ability to read and interpret documents such as submissions, loss control reports, and standard policy form/endorsements. PHYSICAL REQUIREMENTS Office environment - no specific or unusual physical or environmental demands and employees are regularly required to sit, walk, stand, talk, and hear. Role requires approx. 50% travel to meet with clients, attend industry events, and develop new business opportunities. Travel is usually limited to automobile but occasional air travel is required. Requires regular visits to outside locations such as producer's offices. WORK ENVIRONMENT This position operates in a home office environment and requires the frequent use of a computer, telephone, copier and other standard office equipment. Fully remote; WFH/field role covering Chicagoland territory. We are currently not offering employment sponsorship for this opportunity #LI-KK1 #LI-REMOTE The current range for this position is $90,559.93 - $152,723.07 This range is exclusive of fringe benefits and potential bonuses. If hired at ICW Group, your final base salary compensation will be determined by factors unique to each candidate, including experience, education and the location of the role and considers employees performing substantially similar work. WHY JOIN ICW GROUP? • Challenging work and the ability to make a difference • You will have a voice and feel a sense of belonging • We offer a competitive benefits package, with generous medical, dental, and vision plans as well as 401K retirement plans and company match • Bonus potential for all positions • Paid Time Off with an accrual rate of 5.23 hours per pay period (equal to 17 days per year) • 11 paid holidays throughout the calendar year • Want to continue learning? We'll support you 100% ICW Group is committed to creating a diverse environment and is proud to be an Equal Opportunity Employer. ICW Group will not discriminate against an applicant or employee on the basis of race, color, religion, national origin, ancestry, sex/gender, age, physical or mental disability, military or veteran status, genetic information, sexual orientation, gender identity, gender expression, marital status, or any other characteristic protected by applicable federal, state or local law. ___________________ Job Category Underwriting
    $39k-64k yearly est. Auto-Apply 11d ago
  • Associate Underwriter, Workers Compensation

    Amynta Group

    Remote job

    We're thrilled that you are interested in joining us here at the Amynta Group! At BTIS “Be Great” isn't just our motto - it's how we show up every day. As a leading commercial insurance MGA, we're committed to delivering excellence to our retail agency partners and building strong, collaborative relationships with our carrier partners. The BTIS Workers Compensation department is currently looking for Associate Underwriters who share our drive for greatness. In this role, you'll play a pivotal role in the success of underwriting our renewal book of business. What You'll Do: Underwriting: Underwrite workers' compensation renewals with full carrier authority, adhering to underwriting guidelines and metrics to ensure accurate and timely processing. Renewal Processing: Process renewals with all carrier partners, meeting SLAs and guidelines to ensure seamless policy continuation. Broker Management: Review and process broker of record changes, following established procedures to maintain accurate records and compliance. Customer Support: Assist customers with inquiries regarding their policies and renewals via phone, chat, and email, responding promptly and professionally. Request Processing: Process endorsement requests and bind requests, as needed, while adhering to underwriting guidelines to ensure accuracy and efficiency. Team Support: Support senior underwriters with various tasks, prioritizing assignments and meeting deadlines to contribute to team success. What We Look for: 2+ years of recent experience in Workers Compensation customer service. Excellent communication skills and attention to detail. Strong research skills and ability to handle sensitive information. Remote Work Ready: Self-motivated, able to prioritize tasks effectively, multitask with ease, and maintain discipline in a remote work environment, ensuring productivity and meeting performance expectations. Be Great With Us: Join a team that values partnership, innovation, and service excellence. Be part of a growing company with opportunities to make an impact. On-the-Job Training, learn from insurance professionals with over 20 years of experience. Opportunities for career growth and development in a fast-paced industry. Pay and Benefits: Compensation range: $23 to $30 per hour. The exact rate will be based on factors such as geographic location, relevant experience, and skills in relation to the requirements of the role and industry. Comprehensive Benefits: Medical, dental, vision, disability, and life insurance. PTO Benefits: Paid holidays and accrual-based time off. 401(k) with Company Match: Plan for your future with our retirement savings plan. At BTIS, we don't just underwrite policies - we underwrite partnerships. Together, let's Be Great - apply now! About Amynta: Amynta Group is an independent, customer-centered company, providing innovative insurance and protection solutions across a diverse range of customers and industries with more than $3.5 billion in managed premium and 2,000 associates across North America, Europe, and Australia. At Amynta, we are committed to recruiting, developing, promoting, and retaining talented individuals of all backgrounds and life experiences in a safe and welcoming environment. Our teammates, customers, partners, owners, and the communities in which we live and operate benefit from us all nurturing a diverse and inclusive company. About BTIS: As part of the Amynta group, Builders & Tradesmen's Insurance Services, Inc. (BTIS), is a dynamic and rapidly growing insurance MGA focused on offering a wide range of commercial line products to our customers through cutting-edge technology. We maintain a small business attitude and believe in building and fostering solid relationships through communication and genuine concern for our customers. The Amynta Group (the “Company”) is committed to a policy of Equal Employment Opportunity and will not discriminate against an applicant or employee on the basis of any ground of discrimination protected by applicable human rights legislation. The information collected is solely used to determine suitability for employment, verify identity and maintain employment statistics on applicants. Applicants with disabilities may be entitled to reasonable accommodation throughout the recruitment process in accordance with applicable human rights and accessibility legislation. A reasonable accommodation is an adjustment to processes, procedures, methods of conveying information and/or the physical environment, which may include the provision of additional support, in order to remove barriers a candidate may face during recruitment such that each candidate has an equal employment opportunity. The Company will accommodate a candidate to the point of undue hardship. Please inform the Company's personnel representative if you require any accommodation in the application process.
    $23-30 hourly Auto-Apply 34d ago
  • (Remote) California Claims Examiner - Workers Compensation

    Sedgwick 4.4company rating

    Remote job

    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 Claims Examiner - Workers Compensation REMOTE | California Experience 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. **OFFICE LOCATIONS** Position offered remotely. Rancho Cordova & San Diego hybrid if candidate prefers office environment. **PRIMARY PURPOSE OF THE ROLE:** To analyze California jurisdiction Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim. + Negotiating settlement of claims within designated authority. + Communicating claim activity and processing with the claimant and the client. + Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner. **QUALIFICATIONS** Education & Licensing: 5+ years of claims management experience or equivalent combination of education and experience required. + High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred. + Professional certification as applicable to line of business preferred. **Licensing / Jurisdiction Knowledge: California experience required. License may be obtained upon hire.** **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. _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_ **_($71,136 - $95,000_** **_)_** _. 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. #claimsexaminer #claims #remote_ Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers, the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, the San Diego Fair Chance Ordinance, the San Francisco Fair Chance Ordinance, the California Fair Chance Act, and all other applicable laws. 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.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**
    $71.1k-95k yearly 60d+ ago
  • Senior Workers' Compensation Adjuster - Remote (CA Jurisdiction)

    Cannon Cochran Management 4.0company rating

    Remote job

    Overview Workers' Compensation Claim Specialist - Remote (CA Jurisdiction Only) Reporting Location: Concord, CA Branch Schedule: Monday-Friday, 8:00 a.m. - 4:30 p.m. PST Compensation: $85,000 - $97,000 annually Work Setting: Remote (must reside in a location that supports CA claim handling) Build Your Career With Purpose At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success. We don't just process claims-we support people. As the largest privately owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work , and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day. We are seeking an experienced California Workers' Compensation Claim Specialist to join our remote team supporting the Concord, CA branch. This position manages a multiple-account desk handling California jurisdiction only and requires advanced claim handling knowledge, attention to detail, and the ability to balance multiple priorities in a fast-paced environment. Job Summary We are seeking an experienced California Workers' Compensation Claim Specialist to join our remote team supporting the Concord, CA branch. This role manages a multiple-account desk handling California jurisdiction claims exclusively and requires advanced claim-handling expertise, strong attention to detail, and the ability to balance competing priorities in a fast-paced environment. The Claim Specialist is responsible for the investigation, evaluation, and resolution of complex California workers' compensation claims in accordance with CCMSI's best practices, state regulations, and client-specific service standards. This position is well suited for a skilled adjuster seeking a long-term career with an employee-owned organization that invests in its people, technology, and professional growth. Important - Please Read Before Applying This is a true insurance claims adjusting role, not an HR, benefits, safety, consulting, or administrative position. Candidates must have direct experience investigating, evaluating, reserving, negotiating, and resolving claims as an adjuster or adjuster supervisor within a carrier, TPA, or similar claims environment. Applicants without hands-on adjusting experience will not be considered. Responsibilities Investigate, evaluate, and adjust workers' compensation claims within California jurisdiction in compliance with applicable laws and CCMSI standards. Establish and maintain appropriate reserves; authorize or recommend reserves and payments within assigned authority levels. Review, negotiate, and approve medical, legal, and other invoices as appropriate. Coordinate communication among claimants, clients, attorneys, and medical professionals to ensure timely and effective claim resolution. Attend and participate in hearings, mediations, and legal conferences as required. Prepare and maintain accurate, detailed claim documentation in compliance with corporate and client requirements. Monitor subrogation and excess/reinsurance claims as applicable. Deliver high-quality, client-focused service aligned with CCMSI's commitment to excellence. Qualifications Required: 10+ years of progressively responsible experience adjusting California workers' compensation claims. Demonstrated knowledge of California WC statutes, regulations, and case law. Exceptional written and verbal communication skills. Strong organization, multitasking, and time management abilities. Proficiency in Microsoft Office (Word, Excel, Outlook). Reliable, predictable attendance during client service hours. Preferred: SIP certification and/or California Adjuster Certification. AIC designation or other industry credentials. Prior experience with Third Party Administrator (TPA) claims handling. Bilingual (Spanish) proficiency - This role may involve communicating with injured workers, employers, or vendors where Spanish-language skills are beneficial but not required. How We Measure Success Consistent compliance with CCMSI's claim handling standards and state regulations. Supervisor review of claim quality and timeliness. Positive client feedback and adherence to service level expectations. Achievement of key audit and performance goals. What We Offer 4 weeks PTO + 10 paid holidays in your first year • Medical, Dental, Vision, Life, and Disability Insurance • 401(k) and Employee Stock Ownership Plan (ESOP) • Internal training and advancement opportunities • A supportive, team-based work environment Compensation & Compliance The posted salary reflects CCMSI's good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. Visa Sponsorship: CCMSI does not provide visa sponsorship for this position. ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process. Equal Opportunity Employer: CCMSI complies with all applicable employment laws, including pay transparency and fair chance hiring regulations. Our Core Values At CCMSI, we believe in doing what's right-for our clients, our coworkers, and ourselves. We look for team members who: • Act with integrity • Deliver service with passion and accountability • Embrace collaboration and change • Seek better ways to serve • Build up others through respect, trust, and communication • Lead by example-no matter their title We don't just work together-we grow together. If that sounds like your kind of workplace, we'd love to meet you. #EmployeeOwned #GreatPlaceToWorkCertified #CCMSICareers #WorkersCompensation #ClaimsAdjuster #InsuranceCareers #RemoteAdjusterJobs #CaliforniaJobs #NowHiring #JoinOurTeam #LI-Remote We can recommend jobs specifically for you! Click here to get started.
    $85k-97k yearly Auto-Apply 20h ago
  • Senior Workers' Compensation Indemnity Adjuster

    Copperpoint Insurance Companies 4.7company rating

    Remote job

    CopperPoint has an exciting opportunity for a fully remote Senior Workers' Compensation Indemnity Adjuster. The ideal candidate must possess Nevada jurisdiction technical claims knowledge. The Senior Workers' Compensation Indemnity Adjuster is responsible for analyzing time loss workers' compensation claims to determine compensability. They will also adjudicate claims to ensure timely payment of indemnity and medical benefits due within company standards and in compliance with regulatory requirements. As well as establish and maintain action plans and reserves to ensure pro-active, cost-effective claims management. Job Responsibilities: Analyze and investigate indemnity claims to determine compensability decisions by interpreting and applying laws, rules, and regulations of workers' compensation. Utilize all available resources as appropriate. Build and maintain professional relationships with injured workers, policy holders, brokers and agents through proactive claim management and timely communications. Appropriately document communications and claim management activities. Develop, maintain and adhere to action plans and reserves on indemnity claims while pro-actively managing claims to resolution. Establish and maintain cost drivers and data elements to ensure accurate NCCI and Medicare reporting. Pro-actively manage claims in accordance with company standards and statutory requirements. Ensure timely payment of indemnity and medical benefits. Actively utilize all available cost containment measure and programs. Identify settlement opportunities. Negotiate settlements with claimants and attorneys. Conducts dispute resolution with claimants and attorneys. Testify at hearings when necessary. Qualifications/Competencies: Excellent customer service skills to include initiative, mature judgement and discretion. Bachelor's degree (B. S. or B.A.) in business administration, communications, or a related field from an accredited four-year college or university is preferred. A minimum 2 years related experience in insurance claims operations. Nevada workers compensation claims management experience is required. Experience in one or more of the other states in our region is preferred (AZ, UT, CO, TX, OK, KS, MO, NM) Nevada Adjusters' license is mandatory if applicant resides outside of Nevada. Bilingual in Spanish preferred. Strong technical claims knowledge with prior successful experience in a workers' compensation as well as other commercial lines claims management environment. Knowledge of Department of Insurance (DOI), NCCI, Department of Labor and Employment (CDLE) rules and regulations. Ability to analyze, interpret and apply laws, rules and regulations pertaining to workers' compensation. Ability to stay current with changes to statutory, industry rules and regulations as well as company policies and procedures which may impact claims management. Ability to set priorities, manage time, organize work and meet deadlines. Salary Range: $67,000.00 - $98,000.00 annually Compensation may vary depending on skills, experience, education, and geographical location. In addition to base salary, compensation may include an annual discretionary bonus. Benefits: Employees and their families are eligible to participate in CopperPoint Insurance Companies benefit plans including medical, dental, vision, short-term disability, long-term disability, life insurance, a health savings account, a flexible spending account, and a 401k plan. We provide some benefits at no cost to the employee (Basic Life Insurance and AD&D at two times an employee's annual salary, Short- and Long-term Disability coverage, and Employee Assistant Plan). Employees will accrue 0.0769 hours of Paid Time Off (PTO) per paid hour, which may total 20 days a year. In addition, employees will also receive 10 paid holidays throughout the calendar year. Founded in 1925, CopperPoint Insurance Companies is a leading provider of workers' compensation and commercial insurance solutions. With an expanded Line of insurance products and a growing ten-state footprint in the western United States, CopperPoint embodies stability for policyholders in Alaska, Arizona, California, Colorado, Idaho, Nevada, New Mexico, Oregon, Utah, and Washington. CopperPoint Mutual Insurance Holding Company is the corporate parent of Arizona-based CopperPoint Insurance Companies, Alaska National Insurance Company, and other CopperPoint Insurance Entities. CopperPoint's culture of compassion extends to the community through employee volunteerism, corporate matching, Board service, program sponsorships, and in-kind contributions. We empower employees by providing 12 hours of paid volunteer time annually and matching their personal contributions to the charities of their choice up to $500 per year. In 2020, CopperPoint employees reported 3,500 volunteer hours. CopperPoint offers a competitive compensation package and comprehensive benefits package including major medical, dental, and vision, and a wide range of competitive benefits programs, generous matching contributions to your 401(k) plan, generous paid time off, tuition reimbursement, and other education benefits and business casual dress. CopperPoint is an equal employment opportunity employer. All qualified applicants will receive consideration without regard to race, color, sex, religion, age, national origin, disability, veteran status, sexual orientation, gender identity or expression, marital status, ancestry or citizenship status, genetic information, pregnancy status or any other characteristic protected by state, federal or local law. CopperPoint maintains a drug-free workplace. #LI-Remote
    $67k-98k yearly 60d+ ago
  • Remote, Contract-based California Workers Comp Paralegal Opportunity

    The Freelance Firm, LLC 4.5company rating

    Remote job

    Job DescriptionWelcome to The Freelance Firm! We are a national network of experienced, high-level, freelance attorneys and paralegals who provide remote, on-demand support for both short-term and long-term legal projects for our client law firms. Due to increased demand, we are now interviewing for a qualified, experienced and dedicated California-based Workers Comp Paralegal. Remote work hours will vary, but are expected be approximately 5+ hours per week. Paralegal Requirements: - Minimum of 5 years' experience in CA Workers Comp Law - Experienced in all aspects of Workers Comp Law - Case management experiece from inception to settlement - Strong drafting and communication skills to keep cases moving - Well-organized and proven ability to meet deadlines - Self-starter and able to work independently Our Paralegal pay rate starts at $35/hour. We welcome you to join our established network of legal professionals! Please submit your resume and we will contact you for an online meeting if your skills and experience are a good match for this opportunity, or for future opportunities. Resume submissions will be kept in strict confidence. Please visit our website at ************************ to learn more about us and the services we provide!
    $35 hourly 4d ago
  • Assistant Instructor (Part-Time), Master of Social Work, 10X Technology-Assisted Teaching

    SEI 4.4company rating

    Remote job

    The Assistant Instructor is responsible for providing instructional and academic support to learners in courses. This support will be offered through: 1:1 coaching and consultation, instructional materials and resources, and the facilitation of office hours or group study sessions. Essential Duties & Responsibilities: Building an online community conducive to the spirit of learning and continuous improvement in a positive, learner-focused environment. Using text, video, and other technologies to create learning resources that drive learner engagement and assist learners with course content and skill development. Leading and commenting in courseroom discussions with learners. Planning and facilitating optional weekly interactive, collaborative study and review sessions that combine what to learn (content) with how to learn (study strategies). Assessing learning and comprehension through evaluation of course competencies; this may include informal assessments or formal evaluations utilizing rubrics for discussions and assignments. Keeping up to date with essential technologies, including Civitas, Outlook, Kaltura, and more. Maintaining adequate learner records. This position requires 30-35 hours a week and is remote. Most duties can be completed on nights and weekends, but some availability during regular business hours for training, team meetings and learner appointments may also be required. The Assistant Instructor will be expected to check into the courseroom on weekends. Job Skills: Experience with teaching or tutoring. Self-motivated and highly organized. Advocate of social media and mobile technology. Ability to embrace technological and pedagogical methodology changes. Excellent written and verbal communication skills and ability to interact effectively with faculty, coaches, and learners. Demonstrated effective time management skills. Excellent relationship-building, customer service, and problem resolution skills. Demonstrated strong attention to detail, initiative and follow-through. Demonstrated ability to remain calm under pressure and maintain a professional demeanor at all times. Knowledge of adult learning theory and practices such as development of learning contracts, collaborative learning, and active learning strategies Ability to assess individual and group learning needs and explain concepts in different ways. Experience working with a diversity of learning styles. Comfortable using technology to facilitate learning. Work Experience: 2 Years of full time professional social work practice experience post MSW degree conferral. Experience teaching in higher education 1-3 years teaching experience at the graduate level, in an online environment. Education: Must have completed Master of Social Work degree from a regionally accredited College or University, enrollment in a Doctoral program or a completed Doctorate is preferred. Certificates, licenses and registrations: Master Social Work License is required. Must obtain Minnesota Social Work Licensure upon hire and prior to starting the position. Other: Job Location Many of our positions, including this role, are designed to be remote "home office" settings. Employees working out of a home office are responsible for providing an appropriate and safe office space, office furniture and organization, communication tools, and related items. These include: Arranging for high speed internet connection, printer and a dedicated phone line for business use. Specifics regarding expense coverage and reimbursement vary based on individual position categories. Capella will not provide office equipment or on-site set up assistance. The environment must be free from distractions and enable a highly productive and professional work environment. As with on-site positions, our off-site positions require that the majority of the time will be spent using a telephone, PC and monitors. Any and all daycare arrangements must be made so that employees are not working while providing care for children or other family members at home. There are minimal lifting requirements unless otherwise noted. Must be able to travel 10% of time. Must be able to lift 25 lbs. Typical office setting. Mobility within the office including movement from floor to floor. Travel via plane, car, and metro may be required to perform this job. Must be able to work more than 40 hours per week when business needs warrant Access information using a computer. Effectively communicate, both up and down the management chain. Effectively cope with stressful situations Strong mental acuity Regular, dependable attendance and punctuality are essential functions of this job. Other essential functions and marginal job functions are subject to modification. Must be available to work 30 hours per week. $20.00 is the expected starting pay for this position. This offer is based on current budgetary guidelines and additional factors outlined below. SEI offers a comprehensive package of benefits to employees scheduled 30 hours or more per week. In addition to medical, dental, vision, life and disability plans, SEI employees may take advantage of well-being incentives, parental leave, paid time off, certain paid holidays, tax saving accounts (FSA, HSA), 401(k) retirement benefit, Employee Stock Purchase Plan, tuition assistance as well as entertainment and retail discounts. Non-exempt employees are eligible for overtime pay, if applicable. Careers - Our Benefits, Strategic Education, Inc SEI is an equal opportunity employer committed to fostering an inclusive and collaborative culture where individuals can grow their careers and contribute fully. We strive to attract talent with broad experiences, skills and perspectives. We welcome applications from all. While it is not typical for an individual to be hired at or near the top end of the pay range at SEI, we offer a competitive salary. The actual base pay offered to the successful candidate may vary depending on multiple factors including, but not limited to, job-related knowledge/skills, experience, business needs, geographical location, and internal pay equity. Our Talent Acquisition Team is ready to discuss your interest in joining SEI. The expected salary range for this position is below. $17.75 - $27.00 - Hourly If you require reasonable accommodations to complete our application process, please contact our Human Resources Department at *********************** .
    $17.8-27 hourly Auto-Apply 1d ago
  • Workers Compensation Claims Examiner | NY Jurisdictional Knowledge & NY Licensing Required

    Sedgwick 4.4company rating

    Remote job

    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 Jurisdictional Knowledge & NY Licensing Required 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 workers compensation 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. **PRIMARY PURPOSE OF THE ROLE:** We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion. **OFFICE LOCATION** **Syracuse, NY / Hybrid Schedule (only 2 days in-office) - if within reasonable commuting distance to office** **Outside of commutable distance, eligible for remote position** **ARE YOU AN IDEAL CANDIDATE?** To analyze workers compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements. **ESSENTIAL RESPONSIBILITIES** + Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim. + Negotiating settlement of claims within designated authority. + Communicating claim activity and processing with the claimant and the client. + Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner. **QUALIFICATIONS** Education & Licensing: Five years of claims management experience or equivalent combination of education and experience required. + Bachelor's degree from an accredited college or university preferred. + Professional certification as applicable to line of business preferred. **Licensing / Jurisdiction Knowledge: New York** **TAKING CARE OF YOU** + Flexible work schedule. + Referral incentive program. + Opportunity to work in an agile environment. + Career development and promotional growth opportunities. + A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one. Work environment requirements for entry-level opportunities include. Physical: Computer keyboarding Auditory/visual: Hearing, vision and talking Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines. 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. Sedgwick retains the discretion to add or to change the duties of the position at any time. 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 $80-90K. 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. Always accepting applications. 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.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**
    $80k-90k yearly 55d ago
  • Work from Home - CA Workers' Compensation Adjuster | PEO Account Focus

    Ccmsi 4.0company rating

    Remote job

    Overview Workers' Compensation Claim Specialist Schedule: Monday-Friday, 8:00 AM-4:30 PM MST Salary Range: $85,000-$96,000 annually (Depending on experience) Build Your Career With Purpose at CCMSI At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success. We don't just process claims-we support people. As the largest privately owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work , and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day. Job Summary We are looking for an experienced Workers' Compensation Claim Specialist to join our remote team supporting multiple California jurisdiction PEO accounts. At CCMSI, we hire professionals who show strong judgment, ownership, and pride in their work-people who understand that accuracy, empathy, and consistency are the foundation of exceptional claim handling. In this role, you'll be trusted to manage your files independently while contributing to a larger team focused on service excellence, compliance, and client partnership. This position offers the stability of dedicated clients, manageable caseloads, and regular collaboration with a team of seasoned WC professionals. A one-week, in-person onboarding and connection session at our Scottsdale office is available to help you integrate seamlessly into the team. Please note: This is not an HR, administrative, consulting, or advisory support role. This is a true adjusting position. Candidates must have proven experience conducting full investigation, evaluation, negotiation, and resolution of workers' compensation claims, with end-to-end file ownership and decision-making authority. Applicants without direct claims adjusting experience will not be considered. Responsibilities At CCMSI, we hire individuals who take ownership, ask the right questions, and stay ahead of the work. Your ability to organize, prioritize, and resume tasks seamlessly is essential for success. • Investigate, evaluate, and adjust California workers' compensation claims in compliance with state regulations, CCMSI handling standards, and client instructions. • Establish and maintain accurate reserves and thorough documentation within assigned authority levels. • Review, authorize, and process medical, legal, and indemnity payments. • Negotiate claim settlements aligned with jurisdictional guidelines and industry best practices. • Maintain consistent, professional communication with clients, claimants, attorneys, and providers. • Participate in claim reviews, quality audits, and team discussions to support consistency and compliance. • Deliver excellent client service through timely, detailed, and thoughtful claim handling. Qualifications Required: Minimum of 10 years of workers' compensation claim adjusting experience. Proficiency in Microsoft Office (Word, Excel, Outlook). Strong written and verbal communication skills. Proven ability to manage deadlines and multiple priorities effectively. California jurisdiction experience required. Preferred: California SIP certification. Claim review presentation experience. AIC, ARM, or CPCU designation. How We Measure Success Internal audit results and compliance metrics. Annual performance reviews. Timeliness, accuracy, and client satisfaction outcomes. Why You'll Love Working Here 4 weeks PTO + 10 paid holidays in your first year Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP) Career growth: Internal training and advancement opportunities Culture: A supportive, team-based work environment Compensation & Compliance The posted salary reflects CCMSI's good-faith estimate in accordance with applicable pay transparency laws. Actual compensation will be based on qualifications, experience, geographic location, and internal equity. Visa Sponsorship: CCMSI does not provide visa sponsorship for this position. ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process. Equal Opportunity Employer: CCMSI complies with all applicable employment laws, including pay transparency and fair chance hiring regulations. Our Core Values At CCMSI, we believe in doing what's right-for our clients, our coworkers, and ourselves. We look for team members who: Lead with transparency We build trust by being open and listening intently in every interaction. Perform with integrity We choose the right path, even when it is hard. Chase excellence We set the bar high and measure our success. What gets measured gets done. Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own. Win together Our greatest victories come when our clients succeed. We don't just work together-we grow together. If that sounds like your kind of workplace, we'd love to meet you. #EmployeeOwned #GreatPlaceToWorkCertified #CCMSICareers #WorkersCompensation #ClaimsAdjuster #RemoteJobs #CaliforniaJobs #InsuranceCareers #TransportationIndustry #LI-Remote
    $85k-96k yearly Auto-Apply 5d ago
  • Claims Examiner - Workers Compensation - Remote CO

    Sedgwick 4.4company rating

    Remote job

    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 Claims Examiner - Workers Compensation - Remote CO 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? + 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 OFTHE ROLE** : 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 RESPONSIBILITIES MAY INCLUDE:** + 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. + Refers cases as appropriate to supervisor and management. + Performs other duties as assigned. + Supports the organization's quality program(s). + Travels as required. **QUALIFICATIONS & LICENSING** **Education & Experience** 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. _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 ($61,000 - $86,000). 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._ 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.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**
    $61k-86k yearly 14d ago
  • Claims Examiner - Workers Compensation - Remote CO

    Sedgwick 4.4company rating

    Remote job

    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 Claims Examiner - Workers Compensation - Remote CO 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? 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 OFTHE ROLE : 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 RESPONSIBILITIES MAY INCLUDE: 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. Refers cases as appropriate to supervisor and management. Performs other duties as assigned. Supports the organization's quality program(s). Travels as required. QUALIFICATIONS & LICENSING Education & Experience 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. 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 ($61,000 - $86,000). 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. 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.
    $61k-86k yearly Auto-Apply 12d ago
  • (Remote) Claims Examiner - Workers Compensation | AZ, CO, UT Jurisdictions

    Sedgwick 4.4company rating

    Remote job

    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 (Remote) Claims Examiner - Workers Compensation | AZ, CO, UT Jurisdictions 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 OF THE ROLE:** To analyze high-level Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim. + Negotiating settlement of claims within designated authority. + Communicating claim activity and processing with the claimant and the client. + Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner. **QUALIFICATIONS** Education & Licensing: 5+ years of claims management experience or equivalent combination of education and experience required. + High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred. + Professional certification as applicable to line of business preferred. **Licensing / Jurisdiction Knowledge: AZ, CO, UT** **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. _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 (_ 58,764.00 - 82,270.00). _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. #claimsexaminer #claims #remote #LI-remote_ 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.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**
    $37k-58k yearly est. 38d ago
  • (Remote) Claims Examiner - Workers Compensation | AZ, CO, UT Jurisdictions

    Sedgwick 4.4company rating

    Remote job

    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 (Remote) Claims Examiner - Workers Compensation | AZ, CO, UT Jurisdictions 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 OF THE ROLE:** To analyze high-level Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements. **ESSENTIAL RESPONSIBLITIES MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim. + Negotiating settlement of claims within designated authority. + Communicating claim activity and processing with the claimant and the client. + Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner. **QUALIFICATIONS** Education & Licensing: 5+ years of claims management experience or equivalent combination of education and experience required. + High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred. + Professional certification as applicable to line of business preferred. **Licensing / Jurisdiction Knowledge: AZ, CO, UT** **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. _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 (_ 58,764.00 - 82,270.00). _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. #claimsexaminer #claims #remote #LI-remote_ 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.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**
    $62k-89k yearly est. 38d ago
  • Workers Compensation Claims Examiner | NY, NJ, KY Jurisdictions | NY License Preferred | Remote

    Sedgwick 4.4company rating

    Remote job

    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, NJ, KY Jurisdictions | NY License Preferred | Remote 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? To analyze Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements. PRIMARY PURPOSE OF THE ROLE: 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 MAY INCLUDE Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim. Negotiating settlement of claims within designated authority. Communicating claim activity and processing with the claimant and the client. Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner. QUALIFICATIONS Education & Licensing: 3+ years of claims management experience or equivalent combination of education and experience required. High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. Indemnity payments, settlement, litigation experience required Jurisdiction Knowledge: NY, NJ, and KY Licensing: NY preferred; will have to obtain post-hire Sedgwick-funded* 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. 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 (70 - 85K). 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. 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.
    $43k-70k yearly est. Auto-Apply 38d ago
  • Workers Compensation Claims Examiner | Dedicated Client | NY Licensing Required | Remote

    Sedgwick 4.4company rating

    Remote job

    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 | Dedicated Client | NY Licensing Required | Remote 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?** To analyze **New York** **Workers Compensation Lost-Time** claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements. **PRIMARY PURPOSE OF THE ROLE:** 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 MAY INCLUDE** + Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim. + Negotiating settlement of claims within designated authority. + Communicating claim activity and processing with the claimant and the client. + Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner. **QUALIFICATIONS** Education & Licensing: **1 - 3 years of New York Workers Compensation claims management experience** High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. **Jurisdiction Knowledge: New York** **Licensing: New York** **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. 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 (80K - 90K). 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. Always accepting applications. \#remote \#LI-remote 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.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**
    $50k-78k yearly est. 60d+ ago

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