California Workers' Comp Claims Specialist

Sedgwick; Concord (CA); Hybrid; USD 80,000 - 100,000; Full time

Benefits offered by this job

Flexible schedule

Career development

Comprehensive benefits

401K on day one

Job summary

Sedgwick in Concord, CA is seeking a Workers' Compensation Claims Examiner to analyze complex California claims and determine benefits due. This role involves handling litigated and high-exposure cases, complex investigations, and settlement negotiations with clients across industries.

Ideal candidates have CA WC claims management experience, knowledge of California jurisdiction, and a Bachelor’s degree. Sedgwick offers hybrid work, comprehensive benefits, and opportunities for professional

Qualifications

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

Responsibilities

• Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine exposure; manages claims through action plans to resolution.
• Negotiates settlement of claims within designated authority.
• Calculates and assigns reserves; manages reserve adequacy throughout the life of the claim.
• Calculates and pays benefits; approves timely claim payments and adjustments; settles claims within authority level.
• 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 professionally.

Skills

California WC experience

Litigation handling

Settlement negotiations

Education

Bachelor's degree

Job description

Sedgwick in Concord, CA is seeking a Workers' Compensation Claims Examiner to analyze complex California claims and determine benefits due. This role involves handling litigated and high-exposure cases, complex investigations, and settlement negotiations with clients across industries.

Ideal candidates have CA WC claims management experience, knowledge of California jurisdiction, and a Bachelor’s degree. Sedgwick offers hybrid work, comprehensive benefits, and opportunities for professional