Claims Examiner Workers Compensation I CA experienced required I Remote

Sedgwick; United States; On-site; USD 63,404 - 95,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development opportunities

Comprehensive benefits offering

Job summary

Sedgwick is seeking a Claims Analyst in the United States to analyze workers' compensation claims and ensure compliance with service expectations. The role requires 5 years of claims management experience and entails responsibilities such as negotiating settlements, processing claims, and communicating effectively with clients. With a focus on career development, this position offers a flexible work schedule and a comprehensive benefits package including medical, dental, vision, and a 401k plan.

Qualifications

• 5 years of claims management experience or equivalent education/experience.
• Professional certification as applicable to the line of business preferred.
• Knowledge of California licensing/jurisdiction.

Responsibilities

• Analyze and process claims to timely resolution.
• Negotiate settlement of claims.
• Communicate claim activity with clients and claimants.
• Report claims to the excess carrier professionally.

Skills

Claims management

Negotiation skills

Communication

Analytical thinking

Education

High School Diploma or GED

Bachelor's degree

Job description

Primary Purpose of the Role

We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

Are You an Ideal Candidate?

To analyze California 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.

Essential 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.

Qualifications

Education & Licensing: 5 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.


• Professional certification as applicable to line of business preferred.

Licensing / Jurisdiction Knowledge: California.

Taking Care of You

• Flexible work schedule.


• Referral incentive program.


• Opportunity to work in an agile environment.


• Career development and promotional growth opportunities.


• A diverse and comprehensive benefits offering including medical, dental, vision, 401K on day one.

Work Environment Requirements for Entry Level Opportunities

• Physical: Computer keyboarding.


• Auditory/visual: Hearing, vision and talking.


• Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.

Compensation

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 $63,404 - $95,000/yr. 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.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.