Workers Compensation Claims Examiner

Workers Compensation Claims Examiner – Roseville, CA Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands? Responsibilities Apply your knowledge and experience to adjudicate complex customer claims in an energetic culture. Deliver innovative customer‑facing solutions to clients in virtually every industry, including some of the world’s most respected organizations. Be a part of a rapidly growing, industry‑leading global company known for its excellence and customer service. Leverage Sedgwick’s broad, global network of experts to learn from and share your insights. Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career. Enjoy flexibility and autonomy in your daily work, location, and career path. Access diverse and comprehensive benefits to take care of your mental, physical, financial, and professional needs. Analyze complex or technically difficult California workers’ compensation claims to determine benefits due. Handle high‑exposure claims involving litigation and rehabilitation, ensuring ongoing adjudication of claims within service expectations and client requirements. Identify subrogation of claims and negotiate settlements. Investigate and gather information to determine claim exposure; manage claims through well‑developed action plans to an appropriate and timely resolution. Negotiate settlement of claims within designated authority. Calculate and assign timely reserves to claims; manage reserve adequacy throughout the life of the claim. Calculate and pay benefits due; approve and make timely claim payments and adjustments; settle claims within designated authority level. Prepare necessary state filings within statutory limits. Manage the litigation process; ensure timely and cost‑effective claim resolution. Report claims to the excess carrier and respond to requests for directions promptly. Qualifications Education & Licensing: Bachelor's degree from an accredited college or university preferred. Professional certification applicable to line of business preferred. Experience: Four (4) years of workers’ compensation claims management experience or equivalent combination of education and experience required. Licensing / Jurisdiction Knowledge: California jurisdictional knowledge required; SIP required or must be obtained within one year of hire date. Benefits Flexible work schedule. Referral incentive program. Career development and promotional growth opportunities. Diverse and comprehensive benefits offering including medical, dental, vision, 401(k) on day one. Competitive compensation range of $80,000 - $100,000. Comprehensive benefits package including medical, dental, vision, 401(k) and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. Work Environment Requirements When applicable and appropriate, consideration will be given to reasonable accommodations. 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. Computer keyboarding. Hearing, vision, and talking. Equal Employment Opportunity Statement Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance, the San Diego Fair Chance Ordinance, the San Francisco Fair Chance Ordinance, the California Fair Chance Act, and all other applicable laws. Sedgwick is an Equal Opportunity Employer and a Drug‑Free Workplace. #J-18808-Ljbffr