Hybrid Workers' Comp Claims Specialist

Sedgwick Claims Management Services Ltd; Los Angeles, Fallbrook (CA, CA); Hybrid; USD 80,000 - 95,000; Full time

Benefits offered by this job

Flexible schedule

Referral program

Career development

Benefits package

Job summary

Sedgwick is seeking a Claims Examiner for Workers Compensation in West Hills, CA, operating in a hybrid model with three remote days. The role involves analyzing claims to determine benefits and ensuring adjudication aligns with service expectations and best practices.

Responsibilities include negotiating settlements, communicating with claimants and clients, and coordinating with carriers while benefiting from Sedgwick’s diverse network and development opportunities.

Qualifications

• 5 years of claims management experience or equivalent combination of education and experience required.
• 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.
• SIP required or must be obtained within one (1) year of employment; California workers compensation jurisdictional knowledge required.

Responsibilities

• Analyzing and processing workers compensation claims to determine exposure and benefits.
• Negotiating settlements within designated authority.
• Communicating claim activity with the claimant and client.
• Reporting claims to the excess carrier and responding to directions promptly.

Skills

Claims management

Communication

Analytical thinking

Negotiation

Education

Bachelor's degree (preferred)

High School Diploma or GED

Job description

Sedgwick is seeking a Claims Examiner for Workers Compensation in West Hills, CA, operating in a hybrid model with three remote days. The role involves analyzing claims to determine benefits and ensuring adjudication aligns with service expectations and best practices.

Responsibilities include negotiating settlements, communicating with claimants and clients, and coordinating with carriers while benefiting from Sedgwick’s diverse network and development opportunities.