Claims Adjuster Workers Compensation

Primary Purpose

To provide clients with professional care handling losses or claims regionally unassisted, with the ability to address most complex adjustment issues pertaining to damages and coverage and to assist on large losses with the ability to manage smaller and non‑complex claims. To handle losses and claims for property and casualty insurers.

The ideal candidate has a passion for helping others and understands the urgency to provide timely and quality reports to their customers. The candidate also possesses time‑management skills necessary to complete tasks in a timely manner, is well organized, and has the technical skills of estimating and computer skills to perform the job.

• Receive and review new claims and maintain data integrity in the claims system.
• Conduct claim file activities including evaluations, investigations, litigation management, and resolution.
• Review investigative reports, insurance policies, and other pertinent records for proper coverage.
• Investigate the cause and extent of the damages, obtain appropriate documentation and issue settlement.
• Determine coverage of claims with proper limits and deductibles in accordance with policy information.
• Prepare settlement documents and request payment for the claim and expenses.
• Work with external vendors and professionals.
• Interview and correspond with claimants and witnesses regarding claims.
• Estimate cost of repair, replacement, or compensation.
• Prepare report findings and negotiate settlements with claimants.
• Recommend litigation to the legal department when settlement cannot be negotiated.
• Revise case reserves in assigned claims files to cover probable costs.
• Assist in preparing loss‑experience reports to help determine profitability and calculate adequate future rates.

• Bachelor's degree from an accredited college or university preferred but not required.
• Appropriate state adjuster license is required.

Starting pay for this role is $58,331.00 – $81,664.00, depending on skill set, level of experience, and cost of specific location. Benefits include medical, dental, vision, 401(k) and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other voluntary benefits. Competitive salary with a rewarding bonus structure, wellness benefits, and potential flexibility to work from home after training.

Work environment requirements: physical – computer keyboarding; auditory/visual – hearing, vision, talking; mental – clear and conceptual thinking, excellent judgment and discretion, and ability to meet deadlines.

Sedgwick is an Equal Opportunity Employer and a Drug‑Free Workplace.