California Workers' Comp Claims Examiner — Hybrid/Remote

Sedgwick Claims Management Services; California; Hybrid; USD 80,000 - 105,000; Full time

Benefits offered by this job

Flexible schedule

Referral program

Career growth opportunities

Full benefits package

Job summary

Sedgwick Claims Management Services seeks a dedicated Workers' Compensation Claims Examiner in California. The role focuses on analyzing complex CA WC claims, determining benefits, and managing litigated/high-exposure cases with professional discretion.

You will handle investigation, settlement negotiation, and subrogation while ensuring timely adjudication and adherence to client service standards. Hybrid/Remote options are available to CA residents.

Qualifications

• Three (3) years of California workers' compensation claims management experience.
• Licensing or SIP required or obtained within one year of hire.

Responsibilities

• Analyze complex California workers' compensation claims and determine benefits due.
• Manage high-exposure claims involving litigation and rehabilitation.
• Identify subrogation opportunities and negotiate settlements.
• Investigate and gather information to determine claim exposure and escalate as needed.
• Prepare state filings within statutory limits and manage litigation timelines.
• Report claims to excess carriers and respond to directions promptly.

Skills

California workers' compensation

Litigation handling

Claims investigation

Education

Bachelor's degree

Professional certification (WC)

Job description

Sedgwick Claims Management Services seeks a dedicated Workers' Compensation Claims Examiner in California. The role focuses on analyzing complex CA WC claims, determining benefits, and managing litigated/high-exposure cases with professional discretion.

You will handle investigation, settlement negotiation, and subrogation while ensuring timely adjudication and adherence to client service standards. Hybrid/Remote options are available to CA residents.