Claims Examiner - Workers Compensation | Dedicated Client

Sedgwick; United States; Remoto; USD 85.000 - 105.000; Tempo pieno

Vantaggi offerti da questo lavoro

Medical, dental, vision benefits

401K on day one

Flexible schedule

Descrizione del lavoro

Sedgwick is seeking a Claims Examiner for Workers Compensation in California. You will adjudicate complex claims, determine benefits, and ensure service standards for our clients. The role emphasizes analytical rigor, client communication, and adherence to jurisdictional requirements.

Benefits include a strong development path, flexible options, and collaboration with a global network of experts. This position offers competitive compensation and comprehensive benefits from day one.

Competenze

• 3 years of claims management experience or equivalent combination of education and experience required.
• Bachelor’s degree from an accredited college or university preferred.
• Professional certification as applicable to line of business preferred.
• 3 or more years California workers compensation jurisdictional knowledge required, SIP required or must be obtained within one (1) year of employment

Mansioni

• 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

Descrizione del lavoro

By joining Sedgwick, you’ll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve.

Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies

Certified as a Great Place to Work®

Fortune Best Workplaces in Financial Services & Insurance

Claims Examiner - Workers Compensation | Dedicated Client

Are you lookingfor an opportunity to join a global industry leader where you can bring yourbig ideasto help solve problems for some of the world’s best brands?

• Apply your knowledge and experience toadjudicatecomplex workers compensation claims in the context of an energetic culture.
• Deliver innovative customer-facing solutions to clients whorepresentvirtually everyindustry andcomprisesome 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.
• Enjoy flexibility and autonomy in your daily work, your location, and your career path.
• Access diverse and comprehensive benefits to take care of your mental, physical,financialand professional needs.

ARE YOU AN IDEAL CANDIDATE? 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 analyzeWorkers Compensationclaims on behalf of our valued clients todeterminebenefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.

ESSENTIAL RESPONSIBLITIES MAY INCLUDE

• Analyzing and processing claims through well-developed action plans toan appropriateandtimelyresolution by investigating and gathering information todeterminethe 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 andtimelymanner.

QUALIFICATIONS

Education & Licensing: 3 years of claims management experience or equivalent combination of education and experiencerequired.

• High School Diploma or GEDrequired. Bachelor’s degree from an accredited college or university preferred.
• Professional certification as applicable to line of business preferred.

Licensing / Jurisdiction Knowledge: 3 or more years California workers compensation jurisdictional knowledge required, SIP required or must be obtained within one (1) year of employment

TAKING CARE OF YOU

Flexibleworkschedule.

Referralincentiveprogram.

Career development and promotional growth opportunities.

Diverse and comprehensive benefits offering including medical, dental vision, 401K on dayone.

WORK ENVIRONMENT REQUIREMENTS INCLUDE
When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical: Computer keyboarding

Auditory/Visual: Hearing, vision and talking

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $85-105K. 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

Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance, the San Diego Fair Chance Ordinance, the San Francisco Fair Chance Ordinance, the California Fair Chance Act, and all other applicable laws.

Sedgwickis an Equal Opportunity Employer and a Drug-Free Workplace.

If you’re excited about this role but your experience doesn’t align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.