Hybrid CA Workers’ Comp Claims Examiner

Sedgwick Claims Management Services Ltd; Roseville (CA); Hybrid; USD 72,000 - 82,000; Full time

Benefits offered by this job

Flexible schedule

Referral incentive program

Career development and growth

Benefits package on day one

Job summary

Sedgwick is seeking a skilled Claims Examiner for Workers' Compensation to analyze complex claims and determine benefits due. This hybrid role requires CA licensing and a strong background in claims management.

You will collaborate with clients and adjusters to adjudicate, negotiate settlements, and ensure timely resolution. The position emphasizes professionalism, adherence to service standards, and clear communication with claimants.

Qualifications

• Education & Licensing: 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.
• Experience: 5 years of claims management experience or equivalent combination of education and experience required.
• Licensing / Jurisdiction Knowledge: CA Required

Responsibilities

• Analyzing and processing workers compensation claims to determine exposure and resolve within service expectations.
• 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.

Education

High School Diploma or GED

Bachelor's degree (preferred)

Professional certification (as applicable)

Job description

Sedgwick is seeking a skilled Claims Examiner for Workers' Compensation to analyze complex claims and determine benefits due. This hybrid role requires CA licensing and a strong background in claims management.

You will collaborate with clients and adjusters to adjudicate, negotiate settlements, and ensure timely resolution. The position emphasizes professionalism, adherence to service standards, and clear communication with claimants.