Senior Workers' Comp Claims Examiner (Hybrid)

Sedgwick Claims Management Services Ltd; Orange (CA); Hybrid; USD 95,000 - 105,000; Full time

Benefits offered by this job

Referral incentive program

Career development

Comprehensive benefits

Job summary

Sedgwick Claims Management Services Ltd in Orange, CA is seeking a seasoned Workers' Compensation Claims Examiner to analyze claims and determine benefits due, while meeting service expectations. This hybrid role combines autonomous work with collaboration across clients and a supportive team.

You will negotiate settlements within authority, communicate with claimants and clients, and leverage Sedgwick’s network to deliver accurate adjudication and strong client service.

Qualifications

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

Responsibilities

• Analyze workers compensation claims to determine benefits due.
• Negotiate settlements within designated authority.
• Communicate claim activity with the claimant and the client.
• Report claims to the excess carrier and respond to directions promptly.

Skills

Claims management

California WC knowledge

Negotiation

Analytical thinking

Education

High School Diploma or GED

Bachelor's degree preferred

Job description

Sedgwick Claims Management Services Ltd in Orange, CA is seeking a seasoned Workers' Compensation Claims Examiner to analyze claims and determine benefits due, while meeting service expectations. This hybrid role combines autonomous work with collaboration across clients and a supportive team.

You will negotiate settlements within authority, communicate with claimants and clients, and leverage Sedgwick’s network to deliver accurate adjudication and strong client service.