Impactful CA Workers' Comp Claims Examiner

Sedgwick Claims Management Services; San Diego (CA); On-site; USD 80,000 - 100,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development opportunities

Comprehensive benefits: medical,Dental

Job summary

Sedgwick Claims Management Services in California is seeking a Claims Examiner - Workers' Compensation to analyze complex CA WC claims, including high-exposure and litigated cases, ensuring accurate benefits and timely adjudication. You will leverage a broad network to support investigations, settlements, and client service.

Ideal candidates have a California WC claims background, strong analytical skills, and the ability to manage claims through investigations, determinations, settlements, and

Qualifications

• Bachelor's degree from an accredited college or university preferred.
• California jurisdictional knowledge required; SIP certification required or must be obtained within one year of hire date.

Responsibilities

• Analyzes and processes complex or technically difficult California workers' compensation claims by investigating and gathering information to determine exposure and resolve claims.
• Negotiates settlement of claims within designated authority.
• Calculates and assigns reserves; manages reserve adequacy throughout the life of the claim.
• Calculates and pays benefits due; approves and makes timely claim payments and adjustments; settles claims within designated authority level.
• Prepares necessary state filings within statutory limits.
• Manages the litigation process; ensures timely and cost effective claims resolution.
• Reports claims to the excess carrier and responds to directions in a professional and timely manner.

Skills

California workers' compensation

Education

Bachelor's degree

Job description

Sedgwick Claims Management Services in California is seeking a Claims Examiner - Workers' Compensation to analyze complex CA WC claims, including high-exposure and litigated cases, ensuring accurate benefits and timely adjudication. You will leverage a broad network to support investigations, settlements, and client service.

Ideal candidates have a California WC claims background, strong analytical skills, and the ability to manage claims through investigations, determinations, settlements, and