California Workers' Compensation Claims Examiner — Flexible Role

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

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development and promotional成长

Job summary

Sedgwick in California seeks a seasoned Workers' Compensation Claims Examiner to adjudicate complex claims, manage high-exposure files, and ensure timely benefits. You will collaborate with clients, negotiate settlements, and work within a hybrid environment offering development opportunities and a comprehensive benefits package.

Applicants must have five years of claims management experience and California jurisdictional knowledge.

Qualifications

• Bachelor's degree from an accredited college or university preferred.
• Five (5) years of claims management experience or equivalent combination of education and experience required.
• California jurisdictional knowledge required; SIP required or must be obtained within one (1) year of employment.

Responsibilities

• Analyzes and processes complex or technically difficult workers' compensation claims; investigates and gathers information to determine exposure and resolves claims.
• Negotiates settlement of claims within designated authority.
• Calculates reserves and pays benefits; approves and makes timely payments and adjustments; settles claims within authority level.
• Prepares necessary state filings within statutory limits.
• Manages the litigation process and coordinates vendor referrals for investigation or litigation management.
• Ensures claim files are properly documented and claims coding is correct.

Skills

Claims management

Settlement negotiation

Documentation and reporting

Education

Bachelor's degree

California jurisdiction knowledge

SIP license within 1 year

Job description

Sedgwick in California seeks a seasoned Workers' Compensation Claims Examiner to adjudicate complex claims, manage high-exposure files, and ensure timely benefits. You will collaborate with clients, negotiate settlements, and work within a hybrid environment offering development opportunities and a comprehensive benefits package.

Applicants must have five years of claims management experience and California jurisdictional knowledge.