Workers Compensation Claims Examiner

🕒 August 6

🏄 California – Remote

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💵 $80k - $100k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

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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 and appropriate 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 timely to requests for directions • Leverage Sedgwick’s global network of experts and deliver customer-facing solutions

🎯 Requirements

• 4 years of claims management experience or equivalent combination of education and experience required • High School Diploma or GED required • California workers compensation 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 • Professional certification as applicable to line of business preferred • Clear and conceptual thinking ability • Excellent judgment, troubleshooting, problem solving, analysis, and discretion • Ability to handle work-related stress • Ability to handle 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 • Diverse and comprehensive benefits offering including medical, dental vision, 401K on day one • 401k and matching • PTO • Disability and life insurance • Employee assistance • Flexible spending or health savings account • Other additional voluntary benefits • Work-life balance • Flexibility and autonomy in daily work, location, and career path • Professional development opportunities

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