Remote Claims Examiner – Workers’ Comp Specialist

Sedgwick; California; Hybrid; USD 95,000 - 105,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development opportunities

Comprehensive benefits

Job summary

Sedgwick is seeking a seasoned Claims Examiner for California-based roles in Riverside or Ontario. You will analyze workers’ compensation claims, determine benefits, and ensure adjudication aligns with client service requirements. Remote options may apply with a flexible schedule.

Ideal candidates have 3+ years of claims experience, California WC knowledge, and a professional certification relevant to the business. A high school diploma is required; a bachelor’s degree is preferred.

Qualifications

• 3+ years claims management experience or equivalent.
• California workers compensation jurisdictional knowledge required; SIP required or must be obtained within one year.

Responsibilities

• Analyze and adjudicate workers compensation claims.
• Negotiate settlements within designated authority.
• Communicate claim activity with claimant and client.
• Report claims to excess carrier and respond to directions in a timely manner.

Skills

Claims management experience

California WC knowledge

Education

High School Diploma or GED

Bachelor's degree preferred

Professional certification applicable to line of business

Tools

SIP certification (or eligible)

Job description

Sedgwick is seeking a seasoned Claims Examiner for California-based roles in Riverside or Ontario. You will analyze workers’ compensation claims, determine benefits, and ensure adjudication aligns with client service requirements. Remote options may apply with a flexible schedule.

Ideal candidates have 3+ years of claims experience, California WC knowledge, and a professional certification relevant to the business. A high school diploma is required; a bachelor’s degree is preferred.