California WC Claims Examiner — Complex Claims, Flexible

Sedgwick Claims Management Services Ltd; San Diego (CA); Hybrid; USD 80,000 - 100,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401(k) on day one

PTO and disability insurance

Job summary

Sedgwick Claims Management Services Ltd is hiring a California Workers’ Compensation Claims Examiner to analyze complex claims, manage investigations, and settle high-exposure cases. The role emphasizes adjudication, negotiation, and compliance with state regulations.

定位 in Roseville and San Diego areas; offer rewards for exceptional service and a comprehensive benefits package. The ideal candidate will have 4+ years of CA WC claims experience, SIP knowledge, and strong analytical skills.

Qualifications

• Bachelor's degree preferred; professional certification as applicable to line of business preferred.
• Four (4) years of California workers' compensation claims management experience or equivalent.
• California jurisdictional knowledge; SIP required or must be obtained within one year of hire date.

Responsibilities

• Analyzes and processes complex California workers' compensation claims and manages claims through well-developed action plans.
• 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 and responses to requests from excess carrier.

Skills

California workers' compensation

Litigation management

Negotiation skills

Analytical problem solving

Education

Bachelor's degree

SIP certification (or equivalent)

Job description

Sedgwick Claims Management Services Ltd is hiring a California Workers’ Compensation Claims Examiner to analyze complex claims, manage investigations, and settle high-exposure cases. The role emphasizes adjudication, negotiation, and compliance with state regulations.

定位 in Roseville and San Diego areas; offer rewards for exceptional service and a comprehensive benefits package. The ideal candidate will have 4+ years of CA WC claims experience, SIP knowledge, and strong analytical skills.