Claims Examiner – Workers Compensation, CALI Experience

🕒 2 days ago

🇺🇸 United States – Remote

💵 $72.9k - $95k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

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Sedgwick

WebsiteLinkedInAll Job Openings

10,000+ employees

🏢 Enterprise

📋 Compliance

Insurance • Enterprise • Compliance

Sedgwick is a global provider of technology-enabled risk, benefits, and integrated business solutions. They help people and organizations by managing and mitigating risk with solutions in accident, health, disability, unemployment compensation, and liability claims administration, among others. Sedgwick offers services such as claims administration, building consulting, forensic accounting, and forensic engineering. Their specialties include property restoration, brand protection, and loss prevention across several industries, including agriculture, construction, and environmental sectors. The company emphasizes diversity, equity, and inclusion (DEI) as well as environmental, social, and governance (ESG) practices.

📋 Description

• Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; • manages claims through well-developed action plans to an appropriate and timely resolution. • Negotiates settlement of claims within designated authority. • Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles claims within designated authority level. • Manages the litigation process; ensures timely and cost effective claims resolution. • Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.

🎯 Requirements

• Bachelor's degree from an accredited college or university preferred. • Professional certification as applicable to line of business preferred. • Five (5) years of claims management experience or equivalent combination of education and experience required.

🏖️ Benefits

• medical • dental • vision • 401k and matching • PTO • disability and life insurance • employee assistance • flexible spending or health savings account • other additional voluntary benefits