Remote California Workers' Comp Claims Examiner

Sedgwick; California; Remote; USD 80.000 - 105.000; Vollzeit

Benefits dieser Stelle

Flexible schedule

Referral program

Career development

Health benefits

Zusammenfassung

Sedgwick is seeking a Remote Workers' Compensation Claims Examiner for the California jurisdiction. The role focuses on analyzing complex CA WC claims, including high-exposure and litigated matters, with responsibilities spanning investigation, benefit determinations, settlements, and subrogation where applicable.

The ideal candidate has CA WC claims experience, SIP certification (or willingness to obtain within a year), and a track record in managing claims through investigation to resolution.

Qualifikationen

• Bachelor's degree required; professional certification as applicable to line of business preferred.
• Three years of California workers' compensation claims management experience or equivalent.
• California jurisdiction knowledge required; SIP certification preferred or must be obtained within one year of hire.

Aufgaben

• Analyze and process complex California workers' compensation claims by investigating information to determine exposure; manage claims to resolution.
• Negotiate settlements within designated authority.
• Calculate and assign reserves; manage reserve adequacy throughout the life of the claim.
• Calculate and pay benefits; approve and adjust claims; settle within authority.
• Prepare necessary state filings within statutory limits.
• Manage litigation processes; ensure timely, cost-effective resolution.
• Report claims to excess carrier and respond to directions professionally.

Kenntnisse

California workers' comp exp

Litigation handling

Negotiation

Ausbildung

Bachelor's degree

Tools

SIP certification

Jobbeschreibung

Sedgwick is seeking a Remote Workers' Compensation Claims Examiner for the California jurisdiction. The role focuses on analyzing complex CA WC claims, including high-exposure and litigated matters, with responsibilities spanning investigation, benefit determinations, settlements, and subrogation where applicable.

The ideal candidate has CA WC claims experience, SIP certification (or willingness to obtain within a year), and a track record in managing claims through investigation to resolution.