Workers Compensation Claims Examiner | Riverside, CA

Sedgwick • Riverside, IA

4d • $85,000 - $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 ongoing adjudication within service expectations, industry best practices, and specific client service requirements. This role is based in Riverside, California, with a hybrid work arrangement. The ideal candidate is a seasoned California workers compensation examiner who values strong client partnerships, appreciates a reasonable caseload, and works within 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 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 well-developed action plans, investigating and gathering information to assess claim exposure and reach an appropriate, timely resolution.
• 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 direction.

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.
• Disability and life insurance.
• Employee assistance program.
• Flexible spending account 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