Remote CA Workers' Comp Claims Examiner

Sedgwick; United States; Remote; USD 80,000 - 105,000; Full time

Benefits offered by this job

Medical, dental, vision

401k and matching

PTO on start

Job summary

Sedgwick is seeking a Remote Workers Compensation Claims Examiner for the California jurisdiction. The ideal candidate will analyze complex claims, manage high-exposure cases, and negotiate settlements while adhering to client service expectations.

Three years of CA workers’ comp experience and SIP certification (or within one year) are preferred. This role offers flexible work arrangements with comprehensive benefits, including medical, dental, vision, 401(k) matching, and impactful career

Qualifications

• Bachelor’s degree from an accredited college or university preferred.
• Three (3) years of California workers' compensation claims management experience or equivalent combination of education and experience 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 information to determine exposure.
• Negotiates settlement of claims within designated authority.
• Calculates and assigns reserves to claims and 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 authority level.
• Prepares necessary state filings within statutory limits.
• Manages the litigation process; ensures timely and cost effective resolution.
• Reports claims to the excess carrier and responds to directions promptly.

Skills

California workers' compensation

Jurisdiction knowledge

Education

Bachelor’s degree

SIP certification

Job description

Sedgwick is seeking a Remote Workers Compensation Claims Examiner for the California jurisdiction. The ideal candidate will analyze complex claims, manage high-exposure cases, and negotiate settlements while adhering to client service expectations.

Three years of CA workers’ comp experience and SIP certification (or within one year) are preferred. This role offers flexible work arrangements with comprehensive benefits, including medical, dental, vision, 401(k) matching, and impactful career