Senior Workers' Comp Claims Examiner

Sedgwick Claims Management Services Ltd; Ontario (CA); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

401K on day one

Medical, dental, vision

Job summary

Sedgwick is seeking a Claims Representative for Workers’ Compensation in Ontario, CA. You will analyze complex claims, adjudicate benefits, and support client services while collaborating with a broad network of experts to deliver results.

The role emphasizes collaboration, growth, and a client-focused approach within a flexible, supportive environment. On-site duties at the Ontario office offer strong professional development and advancement opportunities.

Qualifications

• 5 years of claims management experience or equivalent combination of education and experience.
• High School Diploma or GED required.
• Bachelor's degree preferred.
• Nationwide Licensing: Required.
• Location: On-Site at our Ontario, CA office.

Responsibilities

• Analyzes and processes complex or technically difficult general liability claims by investigating and gathering information to determine exposure.
• Manages the litigation process; ensures timely and cost-effective claims resolution.
• Coordinates vendor referrals for additional investigation and/or litigation management.
• Leads team meetings and assigns accountability for follow-up items.
• Gathers important compliance/claims processing information to be presented at team meetings.
• Assists in interviews of adjusters, clerical staff and provides feedback to hiring manager.
• Provides limited assistance to team lead with monthly review of adjuster workloads; notes trends and suggests adjustments.

Skills

Claims management

Licensing knowledge

Communication skills

Education

High School Diploma or GED

Bachelor's degree

Job description

Sedgwick is seeking a Claims Representative for Workers’ Compensation in Ontario, CA. You will analyze complex claims, adjudicate benefits, and support client services while collaborating with a broad network of experts to deliver results.

The role emphasizes collaboration, growth, and a client-focused approach within a flexible, supportive environment. On-site duties at the Ontario office offer strong professional development and advancement opportunities.