California Workers' Comp Claims Specialist

Sedgwick Claims Management Services Ltd; Roseville (CA); Remote; USD 80,000 - 100,000; Full time

Benefits offered by this job

Referral incentive program

Career development opportunities

Comprehensive benefits package

Job summary

Sedgwick Claims Management Services Ltd is seeking a skilled Claims Examiner for California workers' compensation claims. You will adjudicate complex cases, including litigated and high-exposure claims, handling investigation, benefit determinations, settlements, and compliance with CA jurisdiction requirements.

The role emphasizes analysis, negotiation, and timely resolutions, with opportunities for professional development and remote work in a supportive, inclusive environment.

Qualifications

• Bachelor's degree required or equivalent
• 4+ years of California workers' compensation claims management experience
• Knowledge of California jurisdiction; SIP license within 1 year of hire

Responsibilities

• Analyze complex California workers' compensation claims to determine benefits
• Manage claims with litigation and rehabilitation, including settlements
• Investigate, gather information and set reserves; ensure timely payments and cost-effective resolutions
• Oversee state filings, subrogation where applicable, and liaise with clients and carriers

Skills

California WC claims

Litigation management

Negotiation

Analytical thinking

Communication skills

Education

Bachelor's degree

Professional certification

Tools

Claims software

Job description

Sedgwick Claims Management Services Ltd is seeking a skilled Claims Examiner for California workers' compensation claims. You will adjudicate complex cases, including litigated and high-exposure claims, handling investigation, benefit determinations, settlements, and compliance with CA jurisdiction requirements.

The role emphasizes analysis, negotiation, and timely resolutions, with opportunities for professional development and remote work in a supportive, inclusive environment.