Job Details

Job Title: Claims Examiner – Workers Compensation, CA (Remote)

Primary Purpose of the Role
We are looking for driven individuals that embody our caring model and core values that include empathy, accountability, collaboration, growth, and inclusion.

Responsibilities

Analyze California workers compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication within service expectations, industry best practices, and specific client service requirements.

Analyze and process claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.

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 in a professional and timely manner.

Qualifications

5 years of claims management experience or equivalent combination of education and experience.

High School Diploma or GED required. Bachelors degree from an accredited college or university preferred.

Professional certification as applicable to line of business preferred.

Licensing / Jurisdiction Knowledge: California

Benefits & Care

Flexible work schedule.

Referral incentive program.

Opportunity to work in an agile environment.

Career development and promotional growth opportunities.

A diverse and comprehensive benefits offering including medical, dental, vision, 401K on day one.

Work Environment Requirements
Physical: Computer keyboarding

Auditory/visual: Hearing, vision and talking

Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.

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 $63,404 - $95,000/yr. 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.

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

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