Hybrid Workers' Comp Claims Examiner (CA)

Sedgwick; San Diego (CA); Hybrid; USD 80,000 - 100,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive

Career development

Comprehensive benefits

Job summary

Sedgwick is hiring a Workers' Compensation Claims Examiner in California. You will analyze and adjudicate complex workers' compensation claims, determine benefits, and negotiate settlements. The role supports hybrid work arrangements with two in-office days in San Diego or Roseville, CA.

Ideal candidates have 5 years of claims management experience, a preferred Bachelor’s degree, and California jurisdiction knowledge. SIP licensing is expected or to be obtained within one year.

Qualifications

• Bachelor's degree preferred.
• Five (5) years of claims management experience or equivalent.
• California jurisdiction knowledge required; SIP licensing or to obtain within one year.

Responsibilities

• Analyzes and processes complex workers' compensation claims and investigates information for exposure assessment.
• Negotiate settlements within designated authority.
• Calculate and assign reserves; manage reserve adequacy throughout the life of the claim.
• Calculate and pay benefits; approve timely payments and adjustments.
• Coordinate vendor referrals for investigation or litigation management.

Skills

Adjudication of complex claims

Negotiation

Communication

Education

Bachelor's degree preferred

California jurisdiction knowledge

SIP licensing (or to obtain within 1 year)

Job description

Sedgwick is hiring a Workers' Compensation Claims Examiner in California. You will analyze and adjudicate complex workers' compensation claims, determine benefits, and negotiate settlements. The role supports hybrid work arrangements with two in-office days in San Diego or Roseville, CA.

Ideal candidates have 5 years of claims management experience, a preferred Bachelor’s degree, and California jurisdiction knowledge. SIP licensing is expected or to be obtained within one year.