Workers Compensation Claims Representative NY Jurisdiction & NY Licensing Required

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 Representative | NY Jurisdiction & NY Licensing Required We are seeking a highly motivated and experienced Workers' Compensation Claims Representatives to join our team. The ideal candidate will have at least 2 years of claims handling experience, with a strong background in New York jurisdictional regulations and processes. This position is responsible for managing and processing workers' compensation claims, ensuring timely and accurate decisions while adhering to all applicable laws and regulations. We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion. ESSENTIAL RESPONSIBILITIES Independently handle a capped caseload of workers' compensation claims, from inception to resolution, ensuring adherence to company procedures, industry best practices, and regulatory requirements. Ensure compliance with New York workers' compensation laws, including timely filing of reports, adherence to benefit payment timelines, and compliance with statutory requirements. Negotiate settlements of claims within designated authority to reach claim resolution. Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner. Maintain accurate and comprehensive records in the claims management system, documenting all actions, decisions, and correspondence related to each claim. QUALIFICATIONS Experience: Minimum of (2) years of workers' compensation claims handling experience. Experience specifically with New York jurisdictional regulations, including knowledge of New York State Workers' Compensation Board rules and procedures. Experience with Public Entity claims management. Education: High school diploma or equivalent; Strong understanding of workers' compensation claims processes, policies, and legal requirements in New York. Ability to manage multiple claims simultaneously and prioritize workload effectively. Proficiency with claims management software and Microsoft Office Suite (Excel, Word, Outlook). Ability to negotiate settlements and resolve claims disputes effectively. TAKING CARE OF YOU Flexible work schedule. Opportunity to work in an agile or remote environment. Career development and promotional growth opportunities. A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one. excellent judgment, troubleshooting, problem solving, analysis, and discretion; Computer keyboarding Auditory/Visual: Hearing, vision and talking 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. 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 #hybrid #remote Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. 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.