Claims Examiner - Workers Compensation | Dedicated Client
About The Position
The Claims Examiner analyzes Workers Compensation claims on behalf of clients to determine benefits due and ensure claims are adjudicated according to service expectations, industry best practices, and client requirements. This role focuses on California workers compensation claims and supports strong client partnerships within a well-managed intake environment and a reasonable caseload. Sedgwick describes the role as an opportunity to adjudicate complex claims, deliver customer-facing solutions, and work with clients across a range of industries. The company offers flexibility and autonomy in daily work, location, and career development, along with professional development opportunities and comprehensive benefits.
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 using action plans to reach appropriate, timely resolutions.
- 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 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 coverage.
- 401(k) and matching, available on day one.
- Paid time off.
- Disability and life insurance.
- Employee assistance program.
- Flexible spending account or health savings account.
- Additional voluntary benefits.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
