Remote Workers’ Compensation Claims Examiner (Hybrid)

Sedgwick; Saint Paul (MN); Hybrid; USD 72,000 - 95,000; Full time

Benefits offered by this job

Flexible schedule

Referral incentive program

401K on day one

Medical, dental, vision

Job summary

Sedgwick is seeking a Claims Examiner for Workers' Compensation with a hybrid work arrangement in California. The role focuses on analyzing claims, determining benefits, and maintaining ongoing adjudication to meet client service standards.

The ideal candidate has 5 years of claims management experience, a High School Diploma or GED (Bachelor’s preferred), and CA licensing knowledge. Sedgwick offers a supportive culture and comprehensive benefits.

Qualifications

• Education & Licensing: High School Diploma or GED required. Bachelor’s degree preferred. Professional certification as applicable to line of business preferred.
• Experience: 5 years of claims management experience or equivalent combination of education and experience required.
• Licensing / Jurisdiction Knowledge: CA Required

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

Analytical thinking

Negotiation

Communication

Attention to detail

Education

High School Diploma or GED

Bachelor’s degree (preferred)

Professional certification (as applicable)

Job description

Sedgwick is seeking a Claims Examiner for Workers' Compensation with a hybrid work arrangement in California. The role focuses on analyzing claims, determining benefits, and maintaining ongoing adjudication to meet client service standards.

The ideal candidate has 5 years of claims management experience, a High School Diploma or GED (Bachelor’s preferred), and CA licensing knowledge. Sedgwick offers a supportive culture and comprehensive benefits.