Hybrid CA: Workers' Comp Claims Adjuster

Sedgwick Claims Management Services; California; Hybrid; USD 73,000 - 85,000; Full time

Benefits offered by this job

Flexible schedule

Referral incentive

Career development

Comprehensive benefits

Job summary

Sedgwick Claims Management Services in California is seeking a dedicated Workers' Compensation Claims Adjuster to adjudicate mid- to high-level claims and determine benefits under state law. You will manage complex indemnity claims, develop action plans, coordinate return-to-work, and negotiate settlements while maintaining strong client relationships.

The role supports hybrid work options and offers comprehensive benefits; CA residency is required.

Qualifications

• Bachelor's degree from an accredited college or university preferred.
• Four (4) years of California Workers' Compensation claims management experience or equivalent combination of education and experience required.
• California jurisdictional knowledge required; SIP required or must be obtained within one (1) year of employment.

Responsibilities

• Manages workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.
• Develops and manages workers compensation claims' action plans to resolution, coordinates return-to-work efforts, and approves claim payments.
• Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.
• Manages subrogation of claims and negotiates settlements.
• Communicates claim action with claimant and client.
• Ensures claim files are properly documented and claims coding is correct.

Education

Bachelor's degree

Job description

Sedgwick Claims Management Services in California is seeking a dedicated Workers' Compensation Claims Adjuster to adjudicate mid- to high-level claims and determine benefits under state law. You will manage complex indemnity claims, develop action plans, coordinate return-to-work, and negotiate settlements while maintaining strong client relationships.

The role supports hybrid work options and offers comprehensive benefits; CA residency is required.