(Remote) California Claims Examiner - Workers Compensation

Sedgwick; Carson City (NV); Remote; USD 71,000 - 99,000; Full time

Job summary

A leading risk and claims administration partner is seeking a remote Claims Examiner to analyze California Workers Compensation claims. The role requires strong claims management expertise, negotiation skills, and effective communication with clients. Candidates should have at least 5 years of relevant experience, with the flexibility to work from home or in a hybrid model. This position offers a competitive salary package along with diverse benefits.

Benefits

Flexible work schedule

Referral incentive program

Diverse and comprehensive benefits

Qualifications

• 5+ years of claims management experience or equivalent combination of education and experience.
• Professional certification as applicable to line of business preferred.
• California experience required; license may be obtained upon hire.

Responsibilities

• Analyze and process claims to resolution by gathering information.
• Negotiate settlement of claims within designated authority.
• Communicate claim activity and processing to both claimants and clients.

Skills

Claims management experience

Negotiation skills

Communication skills

Analytical skills

Education

High School Diploma or GED

Bachelor's degree preferred

Job description

Overview

By joining Sedgwick, you\'ll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve.

Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies. Certified as a Great Place to Work®. Fortune Best Workplaces in Financial Services & Insurance.

Position: Claims Examiner - Workers Compensation REMOTE | California Experience

Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands?

Responsibilities

• Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.
• Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations.
• Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
• Leverage Sedgwick’s broad, global network of experts to both learn from and to share your insights.
• Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.
• Enjoy flexibility and autonomy in your daily work, your location, and your career path.
• Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

Ideal Candidate

We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

Office Locations

Position offered remotely. Rancho Cordova & San Diego hybrid if candidate prefers office environment.

Primary Purpose of the Role

To analyze California jurisdiction Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.

Essential Responsibilities

• Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
• Negotiating settlement of claims within designated authority.
• Communicating claim activity and processing with the claimant and the client.
• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

Qualifications

• Education & Licensing: 5+ years of claims management experience or equivalent combination of education and experience required.
• High School Diploma or GED required. Bachelor\'s degree from an accredited college or university preferred.
• Professional certification as applicable to line of business preferred.

Licensing / Jurisdiction Knowledge: California experience required. License may be obtained upon hire.

Taking Care of You

• Flexible work schedule.
• Referral incentive program.
• Career development and promotional growth opportunities.
• A diverse and comprehensive benefits offering including medical, dental, vision, 401K on day one.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. For this jurisdiction, the range of starting pay is ($71,136 - $99,000). A comprehensive benefits package is offered including medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other voluntary benefits.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with applicable fair chance laws. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying anyway. Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.

Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides solutions for the rapidly changing and complex risk landscape.