Remote WC Claims Examiner — California

Sedgwick; San Francisco (CA); Hybrid; USD 95,000 - 105,000; Full time

Benefits offered by this job

Flexible schedule

Referral incentive

Career development

Medical insurance

Dental insurance

Vision insurance

Job summary

Sedgwick seeks a seasoned California Workers Compensation Claims Examiner to adjudicate complex claims for a diverse client base in Riverside or Ontario, CA. You will manage a reasonable caseload within a structured intake environment and leverage Sedgwick’s expansive network and resources.

The role emphasizes analytical accuracy, timely resolution, and adherence to client service requirements, with a pathway to professional growth and flexible work arrangements.

Qualifications

• 3 years of claims management experience or equivalent combination of education and experience required.
• High School Diploma or GED required.
• Bachelor's degree from an accredited college or university preferred.
• Professional certification as applicable to line of business preferred.

Responsibilities

• Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
• Negotiating settlement of claims within designated authority.
• Communicating claim activity and processing with the claimant and the client.
• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

Skills

3+ years claims management experience

Education

High School Diploma or GED

Bachelor's degree preferred

Professional certification

Job description

Sedgwick seeks a seasoned California Workers Compensation Claims Examiner to adjudicate complex claims for a diverse client base in Riverside or Ontario, CA. You will manage a reasonable caseload within a structured intake environment and leverage Sedgwick’s expansive network and resources.

The role emphasizes analytical accuracy, timely resolution, and adherence to client service requirements, with a pathway to professional growth and flexible work arrangements.