Senior Workers' Comp Claims Examiner - Remote/On-Site

Sedgwick; Riverside (CA); Hybrid; USD 95,000 - 105,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401K on day one

Job summary

Sedgwick in California seeks a Workers Compensation Claims Examiner to adjudicate complex CA workers comp claims for major clients. This role offers flexibility with on-site or remote work and a supportive, growth‑oriented culture.

You will manage investigations, settlements within authority, and communicate with claimants and clients while upholding service standards. Required is 3+ years of CA claims experience, strong knowledge of CA WC rules, and relevant licensing; a high school diploma at

Qualifications

• Education & Licensing: 3 years of claims management experience or equivalent combination of education and experience required.
• High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.
• Licensing / Jurisdiction Knowledge: 3 or more years California workers compensation jurisdictional knowledge required, SIP required or must be obtained within one (1) year of employment.

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

Claims management

CA workers' compensation knowledge

Education

High School Diploma or GED

Bachelor's degree preferred

Licensing knowledge (SIP)

Job description

Sedgwick in California seeks a Workers Compensation Claims Examiner to adjudicate complex CA workers comp claims for major clients. This role offers flexibility with on-site or remote work and a supportive, growth‑oriented culture.

You will manage investigations, settlements within authority, and communicate with claimants and clients while upholding service standards. Required is 3+ years of CA claims experience, strong knowledge of CA WC rules, and relevant licensing; a high school diploma at