Claims Examiner | Riverside, CA or Ontario, CA

Sedgwick • Ontario, IA

1d • $95,000 - $105,000 • Remote

About The Position

The Claims Examiner analyzes Workers Compensation claims on behalf of clients to determine benefits due, while ensuring claims are adjudicated within service expectations, industry best practices, and client-specific requirements. The role is for a seasoned California Workers Compensation Examiner who values strong client partnerships, a reasonable caseload, and a well-managed intake environment. The position is based in Ontario or Riverside, California, with remote options available.

Requirements

• At least 3 years of claims management experience or an equivalent combination of education and experience.
• High school diploma or GED.
• At least 3 years of California workers compensation jurisdictional knowledge.
• SIP certification is required or must be obtained within one year of employment.

Nice To Haves

• Bachelor's degree from an accredited college or university.
• Professional certification applicable to the line of business.

Responsibilities

• Analyze and process claims through well-developed action plans to reach appropriate and timely resolutions, investigating and gathering 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 professionally and promptly to requests for directions.

Benefits

• Flexible work schedule.
• Referral incentive program.
• Career development and promotional growth opportunities.
• Medical, dental, and vision coverage.
• 401(k) and matching.
• Paid time off (PTO).
• Disability and life insurance.
• Employee assistance.
• Flexible spending or health savings account.
• Additional voluntary benefits.

What This Job Offers

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