Remote Claims Examiner Jobs
Remote Claims Examiner jobs are in active demand across the U.S., with remote-first insurers, distributed managed care organizations, and third-party administrators all hiring for this role. Employers currently posting remote openings include Sedgwick, TRISTAR, and WPS Health Solutions. Scan the live roles below and apply to whichever ones fit.
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Showing 4 of 23+ Remote Claims Examiner jobs
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 | Multi State Jurisdiction | Licensing: CA and FL Required (Hybrid/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?
- 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 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: 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.
Experience: 5 years of claims management experience or equivalent combination of education and experience required.
Licensing: FL required, CA preferred
Jurisdiction: CA, FL, GA, MS, MI, NJ, OK, PA, TN, TX, VI
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.
WORK ENVIRONMENT REQUIREMENTS INCLUDE
When applicable and appropriate, consideration will be given to reasonable accommodations.
Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
Physical: Computer keyboarding, travel as required
Auditory/Visual: Hearing, vision and talking
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.
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 | Multi State Jurisdiction | Licensing: CA and FL Required (Hybrid/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?
- 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 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: 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.
Experience: 5 years of claims management experience or equivalent combination of education and experience required.
Licensing: FL required, CA preferred
Jurisdiction: CA, FL, GA, MS, MI, NJ, OK, PA, TN, TX, VI
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.
WORK ENVIRONMENT REQUIREMENTS INCLUDE
When applicable and appropriate, consideration will be given to reasonable accommodations.
Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
Physical: Computer keyboarding, travel as required
Auditory/Visual: Hearing, vision and talking
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.
See All 23 Remote Claims Examiner Jobs
Find roles that match your experience and apply in just a few clicks.
Find Remote Claims Examiner JobsRemote Claims Examiner Job Market
Who's Hiring
- Sedgwick13
- TRISTAR3
- WPS Health Solutions2
- Gallagher1
- ICW1
Top Industries Hiring
- Government & Public Sector
What Employers Look For
The qualifications that appear most often in remote claims examiner jobs.
- Two or more years of experience examining and resolving insurance claims independently
- Active property and casualty or workers' compensation adjuster license in the hiring state
- Proficiency with claims management systems such as Guidewire, Duck Creek, or similar platforms
- Working knowledge of coverage interpretation, policy language, and applicable state regulations
- Bachelor's degree in business, finance, or a related field, or equivalent work experience
- Professional designation such as AIC, CPCU, or ARM preferred for senior-level positions
Tips for Your Remote Claims Examiner Job Search
Apply early to remote roles that fit
Migrate Mate lists remote claims examiner openings from across the U.S. in one place, so you can find roles that match your background and apply directly without sorting through unrelated postings.
Show async communication skills upfront
Remote claims teams rely heavily on written communication for coverage decisions, file notes, and stakeholder updates. Highlight examples of clear, documented communication in your application materials so hiring managers can see you'll function well without in-person guidance.
Verify your adjuster license before applying
Many remote claims examiner roles require a state adjuster license, and some employers post remote openings that require licensure in multiple states. Confirm which licenses you hold and list each one explicitly, since remote employers often filter applications on this criterion before reviewing anything else.
Demonstrate your remote work setup
Remote claims work involves accessing sensitive claim data and insurance systems from home. Mention a secure, dedicated workspace and familiarity with VPN or multi-factor authentication protocols in your cover materials to address a concern remote employers raise consistently.
Remote Claims Examiner Jobs: Frequently Asked Questions
How do I get a remote claims examiner job?
Target employers that have already built remote claims operations, such as remote-first insurers, national third-party administrators, and distributed managed care companies. Remote hiring managers screen hard for self-direction, clear written communication, and the ability to manage a caseload without in-person oversight. Demonstrating proficiency with claims management software, documentation accuracy, and async collaboration gives you a real edge over candidates with no remote work signal.
Which companies hire remote claims examiners?
Employers currently hiring remote claims examiners include Sedgwick, TRISTAR, and WPS Health Solutions, per current remote listings on Migrate Mate as of November 2026. Remote openings for this role tend to cluster at remote-first insurance carriers, national third-party administrators, and distributed health plan operators that have built the infrastructure to support fully remote claims teams.
Can you get a remote claims examiner job with no experience?
Yes, but remote entry-level claims roles are harder to land because employers expect you to work independently from day one with minimal hand-holding. Remote-first third-party administrators and smaller regional carriers are your most realistic entry points. Showing completed claims coursework, an adjuster license where your state requires one, and a home office setup that signals professionalism can substitute for direct experience when applying remotely.
Do you need a degree for remote claims examiner jobs?
Not always. Many remote employers care more about your claims knowledge, software proficiency, and licensing than a specific degree. A state adjuster license, hands-on experience with claims management platforms, and a demonstrated ability to handle caseloads accurately and independently will carry significant weight, particularly at remote-first carriers and third-party administrators that hire based on output over credentials.
Which industries hire the most remote claims examiners?
Remote claims examiner roles concentrate in Government & Public Sector, based on current remote listings on Migrate Mate as of November 2026. These sectors hire remotely because their claims operations are inherently documentation-driven and system-based, making it straightforward for distributed teams to process, review, and adjudicate claims without a central office.
See All 23 Remote Claims Examiner Jobs
Find roles that match your experience and apply in just a few clicks.
Find Remote Claims Examiner Jobs