CA Workers' Compensation Claims Specialist

Sedgwick Claims Management Services Ltd; California; On-site; USD 80,000 - 105,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Comprehensive benefits package

Job summary

Sedgwick is seeking a Claims Examiner - Workers' Compensation to analyze and adjudicate California WC claims, including litigated and high-exposure cases, with emphasis on timely benefit determinations and settlements.

The ideal candidate holds a Bachelor's degree and at least four years of California WC claims experience, with jurisdiction knowledge and SIP certification or plan to obtain within one year. On-site roles in Roseville and Long Beach, CA with a comprehensive benefits package.

Qualifications

• Bachelor's degree from an accredited college or university preferred.
• Four years of California workers' compensation claims management experience.
• California jurisdictional knowledge; SIP certification required or within one year of hire.

Responsibilities

• Analyzes and processes complex California workers' compensation claims by investigating and gathering information.
• Negotiates settlements within designated authority.
• Calculates and assigns reserves; manages reserve adequacy throughout the life of the claim.
• Calculates and pays benefits; approves and makes timely claim payments and adjustments.
• Prepares necessary state filings within statutory limits.
• Manages the litigation process; ensures timely and cost-effective resolution.
• Reports claims to the excess carrier and responds to directions promptly.

Skills

California WC claims

Education

Bachelor's degree

Job description

Sedgwick is seeking a Claims Examiner - Workers' Compensation to analyze and adjudicate California WC claims, including litigated and high-exposure cases, with emphasis on timely benefit determinations and settlements.

The ideal candidate holds a Bachelor's degree and at least four years of California WC claims experience, with jurisdiction knowledge and SIP certification or plan to obtain within one year. On-site roles in Roseville and Long Beach, CA with a comprehensive benefits package.