Claims Examiner - Workers Compensation | Dedicated Client

Sedgwick; California City (CA); Vor Ort; USD 65.000 - 90.000; Vollzeit

Benefits dieser Stelle

Medical, dental, vision

401K on day one

Flexible work schedule

Career development

Diverse benefits

Zusammenfassung

Sedgwick is seeking a seasoned California Workers' Compensation Examiner to adjudicate complex claims and uphold service levels for diverse clients. In a fast-paced environment, you will analyze claims, gather information, and determine exposure to reach timely resolutions while maintaining strong client partnerships.

You will leverage Sedgwick’s resources and guidelines, manage a reasonable caseload, and contribute to a well‑structured intake environment.

Qualifikationen

• 3 years of claims management experience or equivalent combination of education and experience required.
• High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.

Aufgaben

• Analyze Workers Compensation claims on behalf of clients to determine benefits due and adjudicate within service expectations.
• Develop and implement action plans to resolve claims timely after gathering information and assessing exposure.
• Negotiate settlements within designated authority and communicate claim activity to claimants and clients.
• Report claims to excess carriers and respond to directions promptly and professionally.

Kenntnisse

Judgment

Troubleshooting

Problem solving

Analysis

Discretion

Keyboarding

Ausbildung

High School Diploma or GED

Bachelor's degree preferred

Jobbeschreibung

Fortune Best Workplaces in Financial Services & Insurance

Claims Examiner - Workers Compensation | Dedicated Client Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands?

Apply your knowledge and experience to adjudicate complex workers compensation claims in the context of an energetic culture.

Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations.

Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.

Leverage Sedgwick’s broad, global network of experts to both learn from and to share your insights.

Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.

Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

Seeking a seasoned California Workers Compensation Examiner who values strong client partnerships, enjoys a reasonable caseload, and works within a well‑managed intake environment.

PRIMARY PURPOSE OF THE ROLE:

• To analyze Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
• Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
• Negotiating settlement of claims within designated authority.
• Communicating claim activity and processing with the claimant and the client.
• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

Education & Licensing:

• 3 years of claims management experience or equivalent combination of education and experience required.
• High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.

Benefits:

• Diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
• Excellent judgment, troubleshooting, problem solving, analysis, and discretion; Computer keyboarding
• Auditory/Visual: Hearing, vision and talking
• A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.
• Flexible work schedule.
• Career development and promotional growth opportunities.
• Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

#Claims #ClaimsExaminer

Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.