Remote Workers' Comp Claims Examiner

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

Benefits offered by this job

Flexible schedule

Referral incentive program

Career development growth

Full benefits: medical, dental, vision

Job summary

Sedgwick is seeking a Claims Examiner in Riverside, CA or Ontario, CA. You will analyze workers' compensation claims to determine benefits due, ensure timely adjudication, and support clients with accurate claims processing.

The role requires CA workers' compensation knowledge, 3+ years of experience, and a HS diploma; a bachelor's degree is preferred. A comprehensive benefits package and growth opportunities are included.

Qualifications

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

Responsibilities

• Analyze Workers' Compensation claims to determine benefits due and adjudicate within service expectations.
• Negotiate settlements within designated authority.
• Communicate claim activity with the claimant and client.
• Report claims to the excess carrier and respond to directions promptly.

Skills

Claims management experience

Negotiation

Education

High School Diploma or GED

Bachelor’s degree preferred

Job description

Sedgwick is seeking a Claims Examiner in Riverside, CA or Ontario, CA. You will analyze workers' compensation claims to determine benefits due, ensure timely adjudication, and support clients with accurate claims processing.

The role requires CA workers' compensation knowledge, 3+ years of experience, and a HS diploma; a bachelor's degree is preferred. A comprehensive benefits package and growth opportunities are included.