Claims Examiner – Workers Compensation

🕒 September 2

🌵 Arizona, California, +1 more states – Remote

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💵 $80k - $100k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

🦅 H1B Visa Sponsor

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👻 Ghost score 14%

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Logo of Sedgwick

Sedgwick

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 and gather information to determine claim exposure • Negotiate claim settlements within designated authority • Communicate claim activity and processing with claimants and clients • Report claims to the excess carrier • Respond professionally and promptly to requests for directions

🎯 Requirements

• High School Diploma or GED required • 5 years of claims management experience or equivalent combination of education and experience required • Must be licensed in California or Nevada • Bachelor's degree from an accredited college or university preferred • Professional certification as applicable to line of business preferred • Ability to analyze and process workers compensation claims • Ability to investigate and gather information to determine claim exposure • Ability to negotiate settlements within designated authority • Excellent judgment, troubleshooting, problem solving, analysis, and discretion • Ability to handle work-related stress and multiple priorities simultaneously • Ability to meet deadlines • Computer keyboarding • Hearing, vision, and talking

🏖️ Benefits

• Flexible work schedule • Referral incentive program • Career development and promotional growth opportunities • Medical, dental, vision, 401K and matching on day one • Paid time off (PTO) • Disability and life insurance • Employee assistance • Flexible spending or health savings account • Other additional voluntary benefits • Flexibility and autonomy in daily work, location, and career path • Professional development opportunities

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