Claims Examiner - Workers Compensation | Dedicated Client

Sedgwick • Rancho Cordova, NV

2d • $85,000 - $105,000

About The Position

The Claims Examiner analyzes Workers Compensation claims for clients to determine benefits due and ensure claims are adjudicated within service expectations, industry best practices, and client-specific requirements. The role focuses on California workers compensation claims and is intended for an experienced examiner who values client partnerships, a reasonable caseload, and a well-managed intake environment. The examiner investigates claims, develops action plans, negotiates settlements within authority, communicates with claimants and clients, and coordinates with excess carriers.

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 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 directions professionally and promptly.

Benefits

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