Remote CA Workers' Comp Claims Examiner – Adjudicate

Sedgwick Claims Management Services Ltd; Sacramento, Northern (CA, KY); Hybrid; USD 85,000 - 95,000; Full time

Benefits offered by this job

Flexible schedule

Referral incentive program

Comprehensive benefits (medical, dent,

401(k) and more

Job summary

Sedgwick is hiring a Workers' Compensation Claims Examiner for CA, with on-site or remote options. You will adjudicate complex CA WC claims, determine benefits due, and interact with clients and claimants to maintain service standards.

Ideal candidates have 3+ years of claims management experience and strong CA WC knowledge, with SIP certification within a year. Flexible work options and comprehensive benefits are provided.

Qualifications

• 3 years claims management experience or equivalent combination of education and experience.
• High School Diploma or GED required; Bachelor's degree preferred.
• California workers' compensation knowledge required; SIP certification within 1 year of employment.

Responsibilities

• Analyze workers' compensation claims to determine benefits and adjudicate within service expectations.
• Negotiate settlements within designated authority.
• Communicate claim activity with claimants and clients in a timely manner.
• Report claims to excess carrier and respond to directions professionally.

Skills

California workers' compensation knowl

3+ years claims management experience

SIP knowledge or timeline

Education

High School Diploma or GED

Bachelor's degree preferred

Job description

Sedgwick is hiring a Workers' Compensation Claims Examiner for CA, with on-site or remote options. You will adjudicate complex CA WC claims, determine benefits due, and interact with clients and claimants to maintain service standards.

Ideal candidates have 3+ years of claims management experience and strong CA WC knowledge, with SIP certification within a year. Flexible work options and comprehensive benefits are provided.