Workers Compensation Claims Examiner | Concord, CA

Sedgwick•Concord, CA

3d•$80,000 - $105,000•Hybrid

About The Position

The Workers Compensation Claims Examiner analyzes workers compensation claims on behalf of clients to determine benefits due, while ensuring claims are adjudicated according to service expectations, industry best practices, and client-specific requirements. The role investigates claims, gathers information, develops action plans, and works toward appropriate and timely resolutions. It also negotiates settlements within designated authority, communicates claim activity with claimants and clients, and reports claims to excess carriers while responding to their requests for direction. The position is based in Concord, California, with a hybrid schedule requiring two days onsite. Sedgwick describes the role as suited to a seasoned California workers compensation examiner who values strong client partnerships, a reasonable caseload, and a well-managed intake environment.

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 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 action plans to achieve appropriate and timely resolution.
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.