Remote CA Workers' Comp Claims Examiner

Sedgwick; Tucson (AZ); Remote; USD 80,000 - 100,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development and promotional gro

Job summary

Sedgwick is hiring a Claims Examiner for California workers' compensation, offering remote work flexibility and exposure to high-exposure claims. You will analyze complex claims, determine benefits, negotiate settlements, and manage litigation with a broad client base.

Ideal candidates have CA jurisdiction knowledge, a bachelor’s degree, and at least four years of claims management experience. Sedgwick provides a comprehensive benefits package and opportunities for professional growth.

Qualifications

• Bachelor's degree from an accredited college or university preferred.
• Four (4) years of California workers' compensation claims management experience or equivalent combination of education and experience required.
• California jurisdictional knowledge required; SIP required or must be obtained within one year of hire date.

Responsibilities

• Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
• Negotiates settlement of claims within designated authority.
• Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
• Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.
• Prepares necessary state fillings within statutory limits.
• Manages the litigation process; ensures timely and cost effective claims resolution.
• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

Skills

California workers' compensation

Litigation handling

Settlement negotiation

Analytical thinking

Education

Bachelor's degree

Job description

Sedgwick is hiring a Claims Examiner for California workers' compensation, offering remote work flexibility and exposure to high-exposure claims. You will analyze complex claims, determine benefits, negotiate settlements, and manage litigation with a broad client base.

Ideal candidates have CA jurisdiction knowledge, a bachelor’s degree, and at least four years of claims management experience. Sedgwick provides a comprehensive benefits package and opportunities for professional growth.