Workers Compensation Claims Examiner

🔥 1 minute ago

🏄 California – Remote

🏄 California – Remote

💵 $80k - $100k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

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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

• To analyze Workers Compensation claims on behalf of our valued clients to determine benefits due. • Ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements. • Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim. • Negotiating settlement of claims within designated authority. • Communicating claim activity and processing with the claimant and the client. • Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

🎯 Requirements

• 4 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. • California workers compensation jurisdictional knowledge required.

🏖️ Benefits

• Flexible work schedule. • Referral incentive program. • Career development and promotional growth opportunities. • Diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.