Workers' Comp Claims Examiner | Flexible Schedule & Growth

Sedgwick; California; On-site; USD 65,000 - 85,000; Full time

Benefits offered by this job

Medical, dental, vision

401K on day one

Disability and life insurance

Employee assistance program

Flexible spending or health savings

Job summary

Sedgwick in California is seeking a seasoned Claims Examiner to adjudicate Workers' Compensation claims with a focus on accuracy and client service. This role emphasizes analyzing complex claims, determining benefits due, and maintaining timely adjudication within established guidelines.

The successful candidate will negotiate settlements within authority, communicate progress to claimants and clients, and collaborate with Sedgwick’s extensive network to support effective resolutions and strong

Qualifications

• 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.

Responsibilities

• Analyze Workers Compensation claims on behalf of clients to determine benefits due and adjudicate within service expectations.
• Investigate and gather information to determine exposure on the claim and develop action plans for timely resolution.
• Negotiate settlement of claims within designated authority.
• Communicate claim activity and processing with the claimant and the client.
• Report claims to the excess carrier and respond to directions promptly and professionally.

Skills

Claims management

Client communication

Education

High School Diploma or GED

Bachelor's degree preferred

Tools

Claims processing software

Job description

Sedgwick in California is seeking a seasoned Claims Examiner to adjudicate Workers' Compensation claims with a focus on accuracy and client service. This role emphasizes analyzing complex claims, determining benefits due, and maintaining timely adjudication within established guidelines.

The successful candidate will negotiate settlements within authority, communicate progress to claimants and clients, and collaborate with Sedgwick’s extensive network to support effective resolutions and strong