Remote California Workers' Comp Claims Examiner

Sedgwick; Kansas; Remote; USD 80,000 - 105,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development and growth

Medical, dental, vision, 401(k) on day

Job summary

Sedgwick, a global leader in risk and claims management, seeks a Remote Workers' Compensation Claims Examiner with California experience. You will analyze complex CA claims, manage high-exposure cases, and negotiate settlements while meeting service standards and client requirements.

The ideal candidate has CA jurisdiction knowledge, SIP certification (or willingness to obtain within one year), and a track record of timely, accurate adjudication across investigations, determinations, and

Qualifications

• Bachelor's degree preferred.
• Three (3) years of California workers' compensation claims management experience required.
• California jurisdictional knowledge required; SIP required or within one year of hire.

Responsibilities

• Analyzes and processes complex CA workers' compensation claims; investigates and gathers information for exposure assessment and resolution.
• Negotiates settlements within designated authority.
• Calculates and assigns reserves; ensures reserve adequacy throughout the life of the claim.
• Calculates and pays benefits; approves timely claim payments and adjustments; settles claims within authority.
• Prepares necessary state filings within statutory limits.
• Manages litigation processes; ensures timely and cost-effective resolutions.
• Reports claims to the excess carrier and responds to directions promptly.

Skills

CA WC claims experience

Litigation handling

Settlement negotiation

Investigation process

Education

Bachelor's degree

Tools

SIP certification

Job description

Sedgwick, a global leader in risk and claims management, seeks a Remote Workers' Compensation Claims Examiner with California experience. You will analyze complex CA claims, manage high-exposure cases, and negotiate settlements while meeting service standards and client requirements.

The ideal candidate has CA jurisdiction knowledge, SIP certification (or willingness to obtain within one year), and a track record of timely, accurate adjudication across investigations, determinations, and