Senior Complex Claims Advisor, Workers' Comp (Remote)

Sedgwick; Sacramento (CA); Hybrid; USD 95,000 - 100,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development and promotional op‑

Wide benefits: medical, dental, vision

401K on day one

Job summary

Sedgwick is seeking a California expert Complex Claims Advisor to adjudicate intricate workers’ compensation claims. You’ll apply jurisdictional knowledge, guide the complex claims team, and leverage a broad network to deliver optimal resolutions and robust quality improvement.

The role emphasizes OSIP licensing, litigation strategy, and collaborative leadership across multiple jurisdictions. A flexible schedule and comprehensive benefits accompany a hybrid work arrangement.

Qualifications

• Bachelor's degree preferred.
• Licenses as required for specific jurisdictions.

Responsibilities

• Oversee a complex claim inventory and guide resolution.
• Support claims team as subject matter expert across lines of business and jurisdictions.
• Evaluate exposure and direct action plans for resolution.
• Document clear file notes for stakeholders.
• Lead roundtables and coordinate internal/external resources.
• Provide technical leadership on complex claims and quality improvement.
• Contribute to policy and procedure development.
• Mentor complex claim consultants and team leads.
• Lead calibration exercises to ensure consistency.

Skills

jurisdictional expertise

complex claims adjudication

mentoring and leadership

Education

Bachelor's degree

Job description

Sedgwick is seeking a California expert Complex Claims Advisor to adjudicate intricate workers’ compensation claims. You’ll apply jurisdictional knowledge, guide the complex claims team, and leverage a broad network to deliver optimal resolutions and robust quality improvement.

The role emphasizes OSIP licensing, litigation strategy, and collaborative leadership across multiple jurisdictions. A flexible schedule and comprehensive benefits accompany a hybrid work arrangement.