Claims Examiner Workers Compensation I CA experienced required I Remote
$63.4k - $95kSedgwick
Primary Purpose To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements;and to identify subrogation of claims and negotiate settlements. Essential Functions and Responsibilities Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution. Negotiates settlement of claims within designated authority. Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim. Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles claims within designated authority level. Prepares necessary state filings within statutory limits. Manages the litigation process; ensures timely and cost effective claims resolution. Coordinates vendor referrals for additional investigation and/or litigation management. Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients. Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets. Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner. Communicates claim activity and processing with the claimant and the client; maintains professional client relationships. Ensures claim files are properly documented and claims coding is correct. Refers cases as appropriate to supervisor and management. Additional Functions and Responsibilities Performs other duties as assigned. Supports the organization's quality program(s). Travels as required. Qualification Education & Licensing Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. Experience Five (5) years of claims management experience or equivalent combination of education and experience required. Skills & Knowledge Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business. Excellent oral and written communication, including presentation skills. PC literate, including Microsoft Office products. Analytical and interpretive skills. Strong organizational skills. Good interpersonal skills. Excellent negotiation skills. Ability to work in a team environment. Ability to meet or exceed Service Expectations. Work Environment When applicable and appropriate, consideration will be given to reasonable accommodations. When applicable, consideration will be given to reasonable accommodations. Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines. Physical: Computer keyboarding, travel as required. Auditory/Visual: Hearing, vision and talking. As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $63,404 - $95,000/yr. A comprehensive benefits package is offered including but not limited to medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. #J-18808-Ljbffr
$63.4k - $95k
...Job Title: Claims Examiner – Workers Compensation, CA (Remote) Primary Purpose of the Role We are looking for driven individuals that embody our caring... ...industry best practices, and specific client service requirements. Analyze and process claims through well-developed...Remote workFlexible hours$80k - $100k
...Workers Compensation - Claims Examiner | HYBRID | Riverside, CA By joining Sedgwick, you'll be part of something truly meaningful... ...(3 days in-office, 2 days remote) PRIMARY PURPOSE OF THE ROLE:... ..., and specific client service requirements. ESSENTIAL RESPONSIBILITIES...Remote workWork at officeFlexible hours$80k - $92k
...Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Claims Examiner - Workers Compensation | Jurisdiction: FL,TN,CA,GA | Licensing: FL, GA, TN - Required (Remote) Are you looking for an opportunity to join a global industry leader where you can...Remote workFull timeFlexible hours- ...Description Job Title: Workers' Compensation Adjuster (Fully Remote • California)... ...) — must reside in CA About Us We are... ...service and claims outcomes. Our remote... ...We're seeking an experienced Workers' Compensation... ...adjusters as needed Required Qualifications ~5...Remote workWork at officeFlexible hours
$93.6k - $104k
...Workers Compensation Claims Examiner III Temp Fully Remote Chino Hills - Chino Hills, CA 91709 Overview Salary Range $93,600.00 - $104,000.00 Salary Level Experienced Position Type Temporary Job Shift Day Education... .... This position requires considerable...Remote workTemporary workWork at officeLong distanceShift work- ...Whether you're managing claims, supporting clients,... ...: California Workers Compensation Active Adjusters' licenses : CA Designation required. SIP optional. Location... ...eligible for fully remote work How you'... ...a key member of our experienced Claims Adjuster team...Remote work
$50 - $52 per hour
...A staffing firm based in California is seeking a Workers' Compensation Claims Adjuster to manage California Workers' Compensation Indemnity claims from inception to closure. This remote position requires at least 3 years of experience with California Workers' Compensation...Remote workHourly pay$80k - $100k
...Financial Services & Insurance Workers Compensation Claims Examiner Are you looking for an... ...LOCATIONS Rancho Cordova, CA (Hybrid - 2 days onsite)... ...and specific client service requirements; and to identify... ...#ClaimsExaminer #Hybrid #LI-Hybrid #LI-Remote #LI-AM1 Qualified...Remote workWork at officeFlexible hours$80k - $100k
## Workers Compensation Claims ExaminerBy joining Sedgwick, you'll be... ...Compensation Claims Examiner* Apply your knowledge... ...LOCATIONS** Roseville, CA (Hybrid)San Diego, CA... ...specific client service requirements; and to identify... ...#Hybrid #LI-Hybrid #LI-Remote #LI-AM1Qualified applicants...Remote workWork at officeFlexible hours$61k - $113k
...00 Job Category: Claims Description Are you... ...opening for a Workers Compensation Claims Specialist... ...AZ; and will be required to work onsite twice... ...residing in CA and WA will be considered... ...for 100% remote work. Please note... ...independent medical examiners. Refers to claim...Remote workFull timeWork experience placementLocal area$67k - $126k
...00 Job Category: Claims Description Are you... ...for a Senior Workers Compensation Claims Specialist... ...AZ; and will be required to work onsite twice... ...Candidates residing in CA and WA will be... ...for 100% remote work. Please note... ...independent medical examiners. Refers to claim...Remote workFull timeWork experience placementLocal area- ...to candidates outside CA, however, min 5 Years of CA Claims experience is mandatory... ...Years of experience Remote in CA Primary Purpose... ...technically difficult workers' compensation claims to determine benefits... ...client service requirements; and to identify subrogation...Remote work
$36.53 - $38.46 per hour
...Overview: We are seeking an experienced Workers’ Compensation Claims Examiner III to support a high-volume claims... .... This is a fully on-site position requiring in-office attendance five (5) days per week with no hybrid or remote option available. Under minimal supervision...Remote workHourly payFull timeContract workWork at office- ...Role Summary The Claims Examiner II/III is a senior-level... ...full lifecycle of workers’ compensation indemnity claims,... ...resolution. The position requires strong analytical... ...opportunity for an experienced claims professional... ...Type Work Type: REMOTE Office Presence:...Remote workWork at office
- ...Job Description Job Description Worker Compensation Claims Adjuster Workers' Compensation Claims Adjuster - Assist a Dynamic Team in Glendale, CA We're seeking an experienced and motivated Workers' Compensation Claims Adjuster to assist our team in Rocklin....
- ...steps. Our partner is looking for a Claims Examiner Workers Compensation I – SE jurisdictions based in the... ...in line with regulatory and client requirements. You will analyze complex claims files... ...process. Working in a fast-paced, remote-friendly environment, you will...Remote jobFull timeFlexible hours
- ...Whether you're managing claims, supporting clients,... ...: This role is fully remote work. How you’ll make... ..., and ethics requirements. Document and communicate... ...experience adjusting a workers compensation desk, including lost... ...a key member of our experienced Claims Adjuster team,...Remote workWork at officeLocal areaFlexible hours
- ...Whether you're managing claims, supporting clients,... ...Adjusters’ License required: California, SIP optional... ...: This role is fully remote work. How you'll... ...Claims Background: Workers Compensation • Jurisdictional... ...a key member of our experienced Claims Adjuster team,...Remote workFull timeLive outWork at officeLocal areaFlexible hours
$28.69 - $46.21 per hour
...Description The Senior Claims Specialist handles... ...and high-profile Workers' Compensation claims following company... .... This is a remote position. ESSENTIAL... ...Certification as an experienced Examiner PAY RANGE: CorVel... ...local minimum wage requirements, the geographic...Remote workHourly payMinimum wageFull timeLocal areaFlexible hours$29.35 - $47.28 per hour
...Description The WC Senior Claims Specialist handles... ...and high-profile Workers' Compensation claims following... ...CorVel. This is a remote position but candidate... ...or license as an experienced claims adjuster Current... ...local minimum wage requirements, the geographic...Remote workHourly payMinimum wageFull timeWork at officeLocal areaFlexible hours$60.23k - $90k
...Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Claims Examiner Workers Compensation I CA experience required Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to...Full timeFlexible hours$63.4k - $85k
...Claims Examiner - Workers Compensation (Remote) Primary Purpose of the Role We are looking for driven individuals that embody our caring counts model... ...best practices, and specific client service requirements. Essential Responsibilities Analyzing and processing...Remote workFlexible hours$63.4k - $95k
...A claims management firm is seeking a Claims Examiner focused on California workers compensation claims. Responsibilities include analyzing claims, negotiating settlements, and client communication. Ideal candidates will have at least 5 years of claims management experience...Remote workFlexible hours$80k - $90k
...Role Overview This role requires an individual to analyze Lost‑Time Workers Compensation claims on behalf of clients to determine benefits due and ensure ongoing adjudication... ...if within commutable distance to Syracuse, NY; Remote otherwise. Equal Opportunity Statement Sedgwick...Remote workFlexible hours$63.4k - $95k
...A leading insurance firm is seeking a Claims Examiner to analyze California workers compensation claims for clients. The ideal candidate will be responsible for... ..., and communicating with claimants. The position requires 5 years of claims management experience and a high...Remote workFlexible hours$85k - $95k
...Job Summary Acrisure is seeking a Workers’ Compensation Claims Examiner to manage California-based workers’... ...CWCP) designation. This is a fully remote position; candidates must support... ...California Labor Code and regulatory requirements Conduct thorough investigations,...Remote workWork at office- ...A leading claims management provider is seeking a Claims Examiner for Workers Compensation in California. The role involves analyzing claims, negotiating settlements, and... ...career development opportunities. This is a remote position based in Denver, Colorado. #J-18808-...Remote workFlexible hours
- ...A leading claims management company in Salem, Oregon, seeks a Claims Examiner specializing in Workers Compensation. The ideal candidate will analyze California workers compensation claims to determine benefits, negotiate settlements, and communicate with clients through...Remote workFlexible hours
$100k - $220k
...Workers' Compensation Defense Associate Attorneys Locations: CA (Agoura Hills, Oxnard, Encino, Inland Empire... ...Sacramento, San Diego) FULL REMOTE IN CALIFORNIA IS FINE... ...defense experience REQUIRED Experience... ...hands-on experience from experienced practitioners. The firm...Remote workTemporary workWork at office- ...Workers Compensation Claims Examiner | NY Jurisdiction & Subrogation Experience & NY Licensing Required ARE YOU AN IDEAL CANDIDATE? To analyze Lost-Time Workers Compensation claims... ...commutable distance to the Syracuse, NY office Remote if outside of commutable distance...Remote workWork at officeFlexible hours
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