Remote/Hybrid CA Workers' Comp Claims Examiner

Sedgwick; Las Vegas (NV); Hybrid; USD 80,000 - 105,000; Full time

Benefits offered by this job

Flexible schedule

Referral incentives

Career development

Comprehensive benefits

Job summary

Sedgwick is seeking a California workers' compensation Claims Examiner to analyze complex claims, determine benefits, and negotiate settlements. You will handle litigated and high-exposure cases, guiding them from investigation through resolution, with focus on accuracy and timely adjudication.

Role supports hybrid or remote work for CA residents, offering professional development and a comprehensive benefits package including medical, dental, vision, and 401(k).

Qualifications

• Bachelor's degree from an accredited college or university preferred.
• Three (3) years of California workers' compensation claims management experience or equivalent combination of education and experience required.
• California jurisdictional knowledge required; SIP required or must be obtained within one year of hire date.

Responsibilities

• Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine exposure; manages claims to resolution.
• Negotiates settlement within designated authority.
• Calculates and assigns reserves; manages reserve adequacy throughout the life of the claim.
• Calculates and pays benefits; approves and makes timely claim payments and adjustments; settles claims within authority.
• Prepares necessary state filings within statutory limits.
• Manages the litigation process; ensures timely and cost-effective resolution.
• Reports claims to the excess carrier and responds to directions professionally.

Skills

California workers' compensation

Litigation handling

Investigation

Education

Bachelor's degree

Job description

Sedgwick is seeking a California workers' compensation Claims Examiner to analyze complex claims, determine benefits, and negotiate settlements. You will handle litigated and high-exposure cases, guiding them from investigation through resolution, with focus on accuracy and timely adjudication.

Role supports hybrid or remote work for CA residents, offering professional development and a comprehensive benefits package including medical, dental, vision, and 401(k).