Workers Compensation Claims Examiner | Brea, CA | Sign-On Bonus Eligible

Sedgwick Claims Management Services Ltd; Brea (CA); Hybrid; USD 85.000 - 105.000; Vollzeit

Benefits dieser Stelle

Flexible work schedule

Referral incentive program

Career development and growth

Comprehensive benefits including 401(k

Zusammenfassung

Sedgwick, a global leader in risk and claims administration, seeks a Workers' Compensation Claims Examiner in Brea, CA. This hybrid role analyzes complex claims, negotiates settlements, and coordinates with claimants and clients to meet service expectations and client requirements.

Qualified candidates will have 5+ years of claims management experience, a California jurisdictional knowledge base, and the potential to obtain SIP within a year.

Qualifikationen

• Bachelor's degree from an accredited college or university preferred.
• Five years of claims management experience or equivalent.
• High School Diploma or GED required.
• California jurisdictional knowledge required; SIP required or must be obtained within one year of start date.

Aufgaben

• Analyzing and processing claims through action plans to resolution.
• Negotiating settlement within designated authority.
• Communicating claim activity to claimant and client.
• Reporting claims to the excess carrier and responding to directions in a timely manner.

Kenntnisse

Claims management

Analytical skills

Communication

Ausbildung

Bachelor's degree

CA SIP license (or to be obtained)

Jobbeschreibung

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance

Workers Compensation Claims Examiner | Brea, CA | Sign-On Bonus Eligible

Office locations Brea, CA - Hybrid (2 days onsite)

PRIMARY PURPOSE

To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.

ESSENTIAL FUNCTIONS and 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.

QUALIFICATIONS

• Bachelor's degree from an accredited college or university preferred.
• Professional certification as applicable to line of business preferred.
• Experience Five (5) 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.
• Licensing / Jurisdiction Knowledge: California jurisdictional knowledge required; SIP required or must be obtained within one (1) year of start date.

TAKING CARE OF YOU

• Flexible work schedule.
• Referral incentive program.
• Career development and promotional growth opportunities.
• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

WORK ENVIRONMENT REQUIREMENTS INCLUDE

• Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines.
• Physical: Computer keyboarding.
• Auditory/Visual: Hearing, vision and talking.

COMPENSATION AND BENEFITS

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $85,000 - $105,000 per year.

• A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

#Claims #ClaimsExaminer #Hybrid #LI-Hybrid #LI-Remote #LI-AM1

Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance, the San Diego Fair Chance Ordinance, the San Francisco Fair Chance Ordinance, the California Fair Chance Act, and all other applicable laws.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company’s expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see sedgwick.com