Workers Compensation Claims Examiner | SIP Required

Sedgwick is a global risk and claims administration partner serving clients across 80 countries. Primary Purpose Analyze complex workers’ compensation claims to determine benefits, oversee litigation and rehabilitation, and ensure timely adjudication according to service expectations and client requirements. Essential Functions and Responsibilities Analyze and process complex or technically difficult workers’ compensation claims to determine exposure and resolve claims. Negotiate settlements within designated authority. Calculate and assign reserves; manage reserve adequacy throughout life of claim. Calculate and pay benefits, approve and make timely claim payments and adjustments, and settle claims. Prepare state filings within statutory limits. Manage the litigation process to ensure timely and cost-effective resolution. Coordinate vendor referrals for investigation or litigation. Apply cost containment techniques, including strategic vendor partnerships. Manage claim recoveries including subrogation, Second Injury Fund recoveries, and Social Security/Medicare offsets. Report claims to excess carrier and respond to requests promptly. Communicate claim activity and processing to claimant and client; maintain professional relationships. Ensure proper documentation and correct claims coding. Refer cases to supervisor or management as appropriate. Additional Functions and Responsibilities Perform other duties as assigned. Support the organization’s quality programs. Travel as required. Qualifications Bachelor’s degree from an accredited college or university (preferred). Professional certification applicable to line of business (preferred). Four (4) years of claims management experience or equivalent combination of education and experience. California jurisdictional knowledge; SIP required. Benefits Competitive salary ($80,000 - $100,000). Medical, dental, vision, 401(k) with matching, paid time off, disability and life insurance. Flexible spending account or health savings account. Referral incentive program. Flexible work schedule and hybrid/remote options. Career development and promotion opportunities. Compliance and Equal Opportunity Sedgwick is an Equal Opportunity Employer and a Drug‑Free Workplace. Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance, the City of Los Angeles Fair Chance Initiative, the San Diego Fair Chance Ordinance, the San Francisco Fair Chance Ordinance, the California Fair Chance Act, and all applicable laws. #J-18808-Ljbffr Sedgwick Claims Management Services Ltd