California Workers' Comp Claims Examiner (Hybrid/Remote)

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

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development

Medical, dental, vision, 401K on day 1

Job summary

Sedgwick is seeking a California Workers' Compensation Claims Examiner to analyze complex claims, determine benefits, and manage settlements with a focus on cost-effective resolutions. The role requires five years of claims management experience and CA-specific knowledge.

Benefits include a flexible work schedule, referral incentives, and a comprehensive package with medical, dental, vision, 401K and more. This position offers hybrid work arrangements and opportunities for career development.

Qualifications

• Bachelor's degree preferred.
• CA jurisdiction knowledge required; SIP certification due within 1 year.

Responsibilities

• Analyze complex workers' compensation claims to determine exposure and benefits.
• Negotiate settlements within designated authority and manage reserves.
• Calculate and pay benefits, and ensure timely claim payments.
• Prepare state filings within statutory limits and manage litigation.
• Coordinate vendor referrals for investigation and/or litigation management.
• Report claim activity to clients and maintain professional relationships.

Skills

Claims adjudication

Negotiation

Analytical thinking

Client communication

CA jurisdiction knowledge

Education

Bachelor's degree

Job description

Sedgwick is seeking a California Workers' Compensation Claims Examiner to analyze complex claims, determine benefits, and manage settlements with a focus on cost-effective resolutions. The role requires five years of claims management experience and CA-specific knowledge.

Benefits include a flexible work schedule, referral incentives, and a comprehensive package with medical, dental, vision, 401K and more. This position offers hybrid work arrangements and opportunities for career development.