Claims Examiner - Workers Compensation | Multi State Jurisdiction | Licensing: CA and FL Required (Hybrid/Remote)

Sedgwick • San Antonio, TX

8d

About The Position

Analyze Workers Compensation claims on behalf of Sedgwick’s clients to determine benefits due, while ensuring claims are adjudicated according to service expectations, industry best practices, and client-specific requirements. The role involves investigating claims, determining exposure, developing action plans, negotiating settlements within designated authority, communicating with claimants and clients, and reporting claims to excess carriers. The position covers multiple jurisdictions and requires Florida licensing; the posting’s title specifies California and Florida licensing, while the qualifications section lists Florida as required and California as preferred.

Requirements

• High school diploma or GED required.
• Five years of claims management experience, or an equivalent combination of education and experience, required.
• Florida license required according to the qualifications section; the job title also specifies California and Florida licensing as required.

Nice To Haves

• Bachelor's degree from an accredited college or university preferred.
• Professional certification applicable to the line of business preferred.
• California license is listed as preferred in the qualifications section.

Responsibilities

• Analyze and process claims using action plans to reach appropriate and timely resolutions.
• Investigate claims 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 and respond to requests for direction professionally and promptly.

Benefits

• Flexible work schedule.
• Referral incentive program.
• Career development and promotional growth opportunities.
• Medical, dental, and vision benefits, and 401(k), available on day one.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED