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

Sedgwick Claims Management Services; EUA; Híbrido; USD 95 000 - 100 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Flexible work schedule

Referral incentive program

Career development opportunities

Comprehensive benefits (medical,Dental

Resumo da oferta

Sedgwick Claims Management Services is seeking an experienced leader to serve as a subject matter expert for the complex claims team. You will guide jurisdictional handling, oversee high‑value cases, and mentor consultants, adjusters and team leads to improve quality and consistency.

Required qualifications include a Bachelor's degree and OSIP certification with California expertise, plus licensing as needed.

Qualificações

• Bachelor's degree from an accredited college or university preferred.
• Industry designation(s) preferred; Licenses as required for specific jurisdictions.
• OSIP certification with California expertise and litigation strategy experience.

Responsabilidades

• Proactively oversee a complex claim inventory by assessing highly complex claims issues and guiding resolution directions.
• Serve as subject matter expert to assist across lines of business on complex claim issues.
• Evaluate exposure and direct action plans for issue or case resolution; document clear file notes for stakeholders.

Conhecimentos

Complex claims handling

Jurisdictional expertise

Mentoring

Leadership

Formação académica

Bachelor's degree

OSIP Certification

California licensure/OSIP licensing

Descrição da oferta de emprego

ARE YOU AN IDEAL CANDIDATE?

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

WORK LOCATIONS

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, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

#claimsexaminer #claims #hybrid #LI-REMOTE

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.

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