Claims Examiner - Workers Compensation | Jurisdiction: CA | Dedicated Client - Remote

Sedgwick Claims Management Services Ltd; Cameron Park, Northern (CA, KY); Hybrid; USD 72,000 - 95,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401k

PTO

Life insurance

Employee assistance

Flexible spending account

Job summary

Sedgwick Claims Management Services Ltd is seeking a Claims Examiner for Workers’ Compensation in California with remote work options. The role focuses on analyzing claims, determining benefits, and maintaining adjudication standards per client requirements.

The ideal candidate has 5+ years of claims management experience, CA licensing knowledge, and a bachelor’s degree is preferred. Sedgwick offers comprehensive benefits and a supportive work environment.

Qualifications

• Education & Licensing: High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.
• Years of claims management experience or equivalent combination of education and experience required.
• Licensing / Jurisdiction Knowledge: CA Required.

Responsibilities

• Analyze Workers' Compensation claims to determine benefits due and adjudicate within service expectations and client requirements.
• Ensure ongoing adjudication aligned with industry best practices and client service standards.

Skills

Claims management experience

Analytical thinking

Problem solving

Ability to meet deadlines

Education

High School Diploma or GED

Bachelor's degree preferred

Job description

## Claims Examiner - Workers Compensation | Jurisdiction: CA | Dedicated Client - RemoteAccess diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.**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**.****QUALIFICATIONS**Education & Licensing: High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.years of claims management experience or equivalent combination of education and experience required.Experience: 5Licensing / Jurisdiction Knowledge: CA RequiredA diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.**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 deadlinesAs 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 (72k-95k) 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 the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see