Remote CA Workers' Compensation Claims Examiner

Sedgwick; Sacramento (CA); Remote; USD 85,000 - 110,000; Full time

Benefits offered by this job

Flexible schedule

Referral incentive

Career development

Benefits package

Job summary

Sedgwick is seeking a California workers' compensation claims professional to analyze complex claims, determine benefits, and handle high-exposure cases including litigation and rehabilitation. You will work with a trusted network to resolve claims efficiently while upholding client service standards.

The ideal candidate has four years of California WC claims experience, CA jurisdiction knowledge, and may hold SIP or be working toward it.

Qualifications

• Bachelor's degree preferred.
• 4 years of California workers' compensation claims management experience or equivalent.
• California jurisdictional knowledge required; SIP certification (or to be obtained within one year of hire).

Responsibilities

• Analyze complex or technically difficult California workers' compensation claims to determine benefits and exposure.
• Negotiate settlements within designated authority.
• Calculate and assign reserves; manage reserve adequacy through the life of the claim.
• Process benefits payments and adjustments; settle claims within authority.
• Prepare state filings within statutory limits and manage litigation processes.
• Report claims to the excess carrier and coordinate with clients and teams.

Skills

California WC claims experience

Litigation knowledge

Education

Bachelor's degree

Professional certification (as applicable)

Job description

Sedgwick is seeking a California workers' compensation claims professional to analyze complex claims, determine benefits, and handle high-exposure cases including litigation and rehabilitation. You will work with a trusted network to resolve claims efficiently while upholding client service standards.

The ideal candidate has four years of California WC claims experience, CA jurisdiction knowledge, and may hold SIP or be working toward it.