Workers Compensation, Claims Adjuster

🔥 19 hours ago

🏄 California – Remote

🏄 California – Remote

💵 $73k - $85k / 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 mid- and higher-level workers compensation claims to determine benefits due • Ensure ongoing adjudication of claims within company standards and industry best practices • Identify subrogation of claims and negotiate settlements • Manage workers compensation claims, determining compensability and benefits due on long-term indemnity claims • Monitor reserve accuracy and file necessary documentation with state agency • Develop and manage claims action plans through resolution • Coordinate return-to-work efforts and approve claim payments • Approve and process assigned claims and manage action plans pursuant to claims or client contracts • Communicate claim actions with claimants and clients • Ensure claim files are properly documented and claims coding is correct • Process complex lifetime medical and/or defined-period medical claims when applicable • Maintain professional client relationships • Support quality programs and perform other assigned duties • Travel as required

🎯 Requirements

• Candidates must reside in California • Four (4) years of California Workers Compensation claims management experience or equivalent combination of education and experience required • California jurisdictional knowledge required • SIP required or must be obtained within one (1) year of employment • Bachelor's degree from an accredited college or university preferred • Ability to analyze claims and determine benefits due • Ability to manage multiple priorities and meet deadlines • Clear and conceptual thinking ability • Excellent judgment, troubleshooting, problem solving, analysis, and discretion • Ability to handle work-related stress • Computer keyboarding • Hearing, vision, and talking

🏖️ Benefits

• Flexible work schedule • Referral incentive program • Career development and promotional growth opportunities • Medical, dental, and vision insurance • 401K and matching on day one • PTO • Disability and life insurance • Employee assistance • Flexible spending or health savings account • Other additional voluntary benefits