Senior Workers' Compensation Claims Specialist

Sedgwick Claims Management Services Ltd; Orange (CA); Hybrid; USD 85,000 - 100,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development and growth

Job summary

Sedgwick is seeking a California Workers’ Compensation Claims Examiner in Orange, CA to analyze claims for benefits due, ensuring adjudication aligns with service expectations and client requirements.

Ideal candidates will have 3+ years of California WC knowledge, strong claims management experience, and relevant licensure/certifications. Flexible scheduling and a comprehensive benefits package are offered.

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.
• Professional certification as applicable to line of business preferred.

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

California WC knowledge

Claims management

Bachelor's degree (preferred)

Education

Bachelor's degree (preferred)

High School Diploma or GED required

Professional certification (as applicable)

Job description

Sedgwick is seeking a California Workers’ Compensation Claims Examiner in Orange, CA to analyze claims for benefits due, ensuring adjudication aligns with service expectations and client requirements.

Ideal candidates will have 3+ years of California WC knowledge, strong claims management experience, and relevant licensure/certifications. Flexible scheduling and a comprehensive benefits package are offered.