Remote CA Workers' Comp Claims Examiner – Flexible Schedule

Sedgwick; Sacramento (CA); Hybrid; USD 80.000 - 105.000; Vollzeit

Benefits dieser Stelle

Flexible schedule

Referral program

Career development

Comprehensive benefits

Zusammenfassung

Sedgwick, a global leader in risk and claims solutions, seeks a Remote Workers' Compensation Claims Examiner focused on California jurisdiction. You will analyze complex CA WC claims, manage investigations, settlements, and subrogation within client service standards.

The role requires CA WC experience, SIP certification preferred or obtainable within a year, and a commitment to high-quality service in a flexible remote/hybrid environment.

Qualifikationen

• Three (3) 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.
• Bachelor's degree in a related field preferred.

Aufgaben

• 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 claims within designated authority level.
• Prepares necessary state filings within statuto ry 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.

Kenntnisse

Claims handling

Investigation

Negotiation

Decision making

Ausbildung

Bachelor's degree

Jobbeschreibung

Sedgwick, a global leader in risk and claims solutions, seeks a Remote Workers' Compensation Claims Examiner focused on California jurisdiction. You will analyze complex CA WC claims, manage investigations, settlements, and subrogation within client service standards.

The role requires CA WC experience, SIP certification preferred or obtainable within a year, and a commitment to high-quality service in a flexible remote/hybrid environment.