Claims Examiner I, Workers Compensation

🔥 6 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $60.2k - $95k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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Sedgwick

WebsiteLinkedInAll Job Openings

10,000+ employees

🏗️ Construction

💼 Consulting

🏥 Healthcare

Construction • Consulting • Healthcare

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

• Analyze workers compensation claims on behalf of clients to determine benefits due • Ensure ongoing adjudication of claims within service expectations, industry best practices, and client service requirements • Analyze and process claims through action plans to timely resolution • Investigate claims and gather information to determine claim exposure • Negotiate settlement of claims within designated authority • Communicate claim activity and processing with claimants and clients • Report claims to the excess carrier • Respond to requests for directions professionally and promptly • Leverage Sedgwick's global network of experts to learn and share insights • Deliver customer-facing solutions to clients across industries

🎯 Requirements

• 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 • Workers compensation claims examination knowledge and experience • California jurisdiction knowledge/licensing • Ability to analyze and process claims • Ability to investigate claims and gather information to determine exposure • Ability to negotiate claim settlements within designated authority • Ability to communicate claim activity and processing with claimants and clients • Ability to report claims to the excess carrier and respond to requests for directions • Computer keyboarding • Hearing, vision, and talking abilities • Clear and conceptual thinking ability • Excellent judgement and discretion • Ability to meet deadlines

🏖️ Benefits

• Flexible work schedule • Referral incentive program • Opportunity to work in an agile environment • Career development and promotional growth opportunities • Medical, dental, and vision insurance • 401(k) and matching • Paid time off (PTO) • Disability and life insurance • Employee assistance • Flexible spending or health savings account • Other additional voluntary benefits • Flexible and autonomous daily work, location, and career path • Professional development opportunities