Workers Compensation Claims Examiner, CA Jurisdiction

🔥 12 hours ago

🌵 Arizona, California, +7 more states – Remote

🌵 Arizona – Remote 🏄 California – Remote 🐊 Florida – Remote 🥔 Idaho – Remote 🎰 Nevada – Remote 🌲 North Carolina – Remote 🌲 Oregon – Remote 🤠 Texas – Remote ⛷️ Utah – Remote

💵 $80k - $105k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

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 and process complex or technically difficult California workers' compensation claims • Investigate claims and gather information to determine claim exposure • Manage claims through action plans to timely and appropriate resolution • Negotiate claim settlements within designated authority • Calculate and assign timely, appropriate reserves and manage reserve adequacy throughout the claim lifecycle • Calculate and pay benefits; approve and make timely claim payments and adjustments • Settle claims within designated authority level • Prepare necessary state filings within statutory limits • Manage the litigation process and ensure timely, cost-effective claims resolution • Report claims to the excess carrier and respond to requests for direction professionally and promptly • Identify subrogation opportunities and negotiate settlements

🎯 Requirements

• California workers' compensation claims experience • Three (3) 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 year of hire date • Bachelor's degree from an accredited college or university preferred • Professional certification as applicable to line of business preferred • Experience handling litigated and high-exposure claims • Knowledge of California jurisdictional requirements • Ability to manage claims through investigation, benefit determination, settlement negotiation, and resolution • Clear and conceptual thinking ability; 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 • Work authorization in the United States implied by eligibility for U.S.-located candidates

🏖️ Benefits

• Flexible work schedule • Referral incentive program • 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 program • Flexible spending or health savings account • Additional voluntary benefits • Remote work / work-at-home arrangement