California Workers' Comp Claims Examiner (Remote)

Sedgwick; United States; Remote; USD 85.000 - 110.000; Vollzeit

Benefits dieser Stelle

Flexible schedule

Referral program

Career development

Comprehensive benefits including: Med,

Dental, Vision, 401K

Zusammenfassung

Sedgwick is hiring a Workers’ Compensation Claims Examiner to analyze complex California claims and determine benefits due. You’ll handle high-exposure cases, including litigation and rehabilitation, ensuring adjudication aligns with client service requirements.

The ideal candidate has CA WC claims management experience, knowledge of jurisdictional rules, and the ability to negotiate settlements and subrogation while maintaining service standards. Remote work options available.

Qualifikationen

• Bachelor’s degree from an accredited college or university preferred.
• Four (4) years of California workers’ compensation claims management experience or equivalent education/experience.
• California jurisdictional knowledge required; SIP certification required or must be obtained within one year of hire date.

Aufgaben

• Analyzes and processes complex or technically difficult workers’ compensation claims by investigating and gathering information to determine exposure on the claim; manages claims through action plans to resolution.
• Negotiates settlement of claims within designated authority.
• Calculates and assigns timely reserves to claims; manages reserve adequacy throughout the life of the claim.
• Calculates and pays benefits due; approves and makes timely claim payments and adjustments; settles claims within designated authority level.
• Prepares necessary state filings within statutory limits.
• Manages the litigation process; ensures timely and cost effective claims resolution.
• Reports claims to the excess carrier and responds to directions in a professional and timely manner.

Kenntnisse

California WC claims

Claims management

Litigation handling

Customer service

Ausbildung

Bachelor’s degree

Jobbeschreibung

Sedgwick is hiring a Workers’ Compensation Claims Examiner to analyze complex California claims and determine benefits due. You’ll handle high-exposure cases, including litigation and rehabilitation, ensuring adjudication aligns with client service requirements.

The ideal candidate has CA WC claims management experience, knowledge of jurisdictional rules, and the ability to negotiate settlements and subrogation while maintaining service standards. Remote work options available.