Hybrid Claims Examiner - Workers' Compensation Specialist

Sedgwick; Portland (OR); Hybrid; USD 72,000 - 95,000; Full time

Benefits offered by this job

Flexible schedule

Referral incentive program

Career development

Health benefits & 401K on day one

Job summary

Sedgwick is seeking a Claims Examiner for Workers' Compensation with California jurisdiction in a hybrid work setting. You will analyze claims, determine benefits due, and adjudicate to meet client service requirements while coordinating with claimants and clients.

The ideal candidate has a High School Diploma or GED, a Bachelor’s degree preferred, and about 5 years of claims management experience, plus CA licensing knowledge.

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 claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
• 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

Professional certification

Job description

Sedgwick is seeking a Claims Examiner for Workers' Compensation with California jurisdiction in a hybrid work setting. You will analyze claims, determine benefits due, and adjudicate to meet client service requirements while coordinating with claimants and clients.

The ideal candidate has a High School Diploma or GED, a Bachelor’s degree preferred, and about 5 years of claims management experience, plus CA licensing knowledge.