Claims Examiner - Workers Compensation | Dedicated Client

Sedgwick; Sacramento (CA); On-site; USD 65,000 - 95,000; Full time

Benefits offered by this job

Flexible work schedule

Career development opportunities

Diverse and comprehensive benefits (m

Job summary

Sedgwick is seeking a seasoned California Workers' Compensation Examiner to analyze complex claims and determine benefits due within a fast-paced intake environment. The role emphasizes adjudication aligned with client service expectations and industry best practices, leveraging Sedgwick's global network for professional growth.

Responsibilities include examining and processing claims, negotiating settlements within authority, and maintaining clear communication with claimants and clients.

Qualifications

• 3 years of claims management experience or equivalent education and experience.
• High School Diploma or GED required; Bachelor's degree preferred.
• Strong analytical, judgment, and communication skills; good computer keyboarding.

Responsibilities

• 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.

Skills

Judgment

Troubleshooting

Problem solving

Analysis

Discretion

Keyboarding

Education

High School Diploma or GED

Bachelor's degree preferred

Job description

Claims Examiner - Workers Compensation

Fortune Best Workplaces in Financial Services & Insurance

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.

Responsibilities

• 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.

Skills & Requirements

• High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.
• excellent judgment, troubleshooting, problem solving, analysis, and discretion; Computer keyboarding
• Auditory/Visual: Hearing, vision and talking

Benefits

• Flexible work schedule.
• Career development and promotional growth opportunities.
• Diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
• 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.

#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.