Senior California Workers' Comp Claims Specialist

Sedgwick; Brea (CA); On-site; USD 80,000 - 100,000; Full time

Benefits offered by this job

Flexible schedule

Referral program

Career development

Benefits package

Job summary

Sedgwick is hiring a Claims Examiner for Workers' Compensation in Brea, CA. The role focuses on analyzing complex California workers' compensation claims, including adjudication, investigation, and high-exposure cases.

You will manage settlements, reserves, and benefits, while coordinating with litigation teams and ensuring timely resolutions. Ideal candidates bring California WC experience, ability to handle litigated claims, and knowledge of governing jurisdiction.

Qualifications

• Bachelor's degree preferred or equivalent
• California jurisdiction knowledge required; SIP certification required or to be obtained within one year

Responsibilities

• Analyzes and processes complex or technically difficult California workers' compensation claims by investigating and gathering information to determine exposure and to resolve the claim.
• Negotiates settlements within designated authority.
• Calculates and assigns reserves; monitors reserve adequacy throughout the life of the claim.
• Calculates and pays benefits; approves and makes timely 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 excess carriers and responds to directions promptly.

Skills

Claims adjudication

Litigation handling

Negotiation

Reserves management

Education

Bachelor's degree

California workers' compensation knowledge

Job description

Sedgwick is hiring a Claims Examiner for Workers' Compensation in Brea, CA. The role focuses on analyzing complex California workers' compensation claims, including adjudication, investigation, and high-exposure cases.

You will manage settlements, reserves, and benefits, while coordinating with litigation teams and ensuring timely resolutions. Ideal candidates bring California WC experience, ability to handle litigated claims, and knowledge of governing jurisdiction.