Remote California Workers' Comp Claims Examiner

Sedgwick; Los Angeles (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 Examiner to analyze complex or high-exposure claims, conduct thorough investigations, determine benefits, negotiate settlements, and adjudicate claims to resolution.

The role requires California jurisdiction knowledge, experience with litigated files, and a commitment to service excellence within flexible, remote work arrangements and a broad benefits program.

Qualifications

• Bachelor's degree from an accredited college or university preferred.
• Four (4) years of California workers' compensation claims management experience or equivalent.
• California jurisdictional knowledge; SIP certification or within one year of hire.

Responsibilities

• Analyze and process complex or technically difficult California workers' compensation claims, gathering information to determine exposure and resolve them timely.
• Negotiate settlements within designated authority.
• Set and manage reserves for claims throughout their life.
• Calculate and pay benefits; approve timely payments and adjustments.
• Prepare required state filings within statutory limits.
• Manage litigation process for cost-effective resolution.
• Report claims to excess carriers and respond promptly to directions.

Skills

California WC experience

Litigation handling

Analytical skills

Education

Bachelor's degree in related field

Job description

Sedgwick is seeking a California workers' compensation Claims Examiner to analyze complex or high-exposure claims, conduct thorough investigations, determine benefits, negotiate settlements, and adjudicate claims to resolution.

The role requires California jurisdiction knowledge, experience with litigated files, and a commitment to service excellence within flexible, remote work arrangements and a broad benefits program.