Remote Workers' Compensation Claims Examiner

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

Benefits offered by this job

Flexible schedule

Referral incentives

Career development

Comprehensive benefits

Job summary

Sedgwick in Riverside, CA is seeking a seasoned Workers’ Compensation Claims Examiner to join our global team. You will analyze complex claims, determine benefits due, and adjudicate within client service requirements.

This role offers flexible work options (on-site or remote) and opportunities for career growth, with a focus on accurate reporting, negotiation, and delivering exceptional client service. Preferred California jurisdiction knowledge and SIP within a year.

Qualifications

• 3 years of claims management experience or equivalent combination of education and experience.
• High School Diploma or GED required; Bachelor's degree preferred.
• California workers' compensation jurisdictional knowledge required; SIP certification within 1 year.

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

Claims management

California WC knowledge

Education

High School Diploma or GED

Bachelor's degree preferred

Job description

Sedgwick in Riverside, CA is seeking a seasoned Workers’ Compensation Claims Examiner to join our global team. You will analyze complex claims, determine benefits due, and adjudicate within client service requirements.

This role offers flexible work options (on-site or remote) and opportunities for career growth, with a focus on accurate reporting, negotiation, and delivering exceptional client service. Preferred California jurisdiction knowledge and SIP within a year.