Complex Claims Advisor - Workers Compensation California Expert - OSIP Licensing - Litigation Strategy & Resolution

Sedgwick; California; Hybrid; USD 95,000 - 100,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development opportunities

Comprehensive benefits

Job summary

Sedgwick is seeking a California expert in complex workers’ compensation claims. You will act as the department subject matter expert, guiding a team to consistently resolve complex matters and improve overall claim handling.

The role emphasizes OSIP-certified expertise and litigation strategy across multiple jurisdictions. The position offers flexible work considerations, professional development, and comprehensive benefits as part of Sedgwick’s commitment to quality service and career growth

Qualifications

• Bachelor's degree from an accredited college or university preferred.
• Licenses as required for specific jurisdictions.
• California expert with OSIP Certification.
• Also specializing in litigation strategy and resolution.

Responsibilities

• Proactively oversee a complex claim inventory and guide handling to optimal resolution.
• Serve as subject matter expert across lines of business and jurisdictions on complex issues.
• Evaluate exposure and direct action plans for issue or case resolution.
• Document clear file notes for stakeholders outlining issues and paths to resolution.
• Facilitate roundtables and coordinate internal/external resources as needed.
• Provide technical leadership and drive ongoing quality improvement on complex claims.
• Support policy and procedure development and mentor team members.
• Lead calibration exercises to ensure consistency.

Skills

Complex claims expert

OSIP Certification

Litigation strategy

Education

Bachelor's degree

Job description

Complex Claims Advisor | Workers Compensation California Expert | OSIP Licensing | Litigation Strategy & Resolution

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

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 customer 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. 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, financial and professional needs.

PRIMARY PURPOSE OF THE ROLE

To act as a department subject matter expert by providing guidance to the complex claims team to ensure consistency resolving matters optimally while creating a culture of continual quality improvement destined to elevate the overall claim handling to benefit our stakeholders; to ensure the consistency in the developed targeted solutions, and technical guidance and oversight provided to claims team.

ESSENTIAL RESPONSIBLITIES MAY INCLUDE

• Proactively and strategically oversee a complex claim inventory by assessing highly complex claims issues, utilizing jurisdictional expertise, providing oversight, and helping direct the handling to achieve the best possible resolution.
• Assists the claims team as their subject matter expert to assist in addition to lines of business and key jurisdictions on complex claim issues.
• Uses knowledge of all aspects of claims handling in evaluating exposure; recommends and directs action plans for issue or case resolution.
• Articulates and documents clear and concise file notes to allow stakeholders to understand the issues and path to resolution.
• Facilitates roundtables with groups/teams; engages appropriate internal and external resources as needed.
• Provides technical leadership on and maintains co-ownership of complex claim issues; creates a culture of continual quality improvement through further influence.
• Assists in the evaluation and development of policies and procedures.
• Mentors and provides guidance to the complex claim consultants, adjusters and team leads
• Leads calibration exercises ensuring consistency through the exchange of ideas and strategies.

QUALIFICATIONS

• Bachelor's degree from an accredited college or university preferred.
• Industry designation(s) preferred.
• Licenses as required for specific jurisdictions.
• California expert with OSIP Certification.
• Also specializing in litigation strategy and resolution
• Licensing: OSIP

TAKING CARE OF YOU

• Flexible work schedule.
• Referral incentive program.
• Career development and promotional growth opportunities.
• A 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 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 (95k - 100K). A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, em