Claims Adjuster - Workers Compensation (West Hills,CA/Remote 3 days)

Job Title and Location Claims Examiner – Workers Compensation (West Hills, CA/Remote 3 days) Primary Purpose of the Role To analyze mid- and higher-level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements. Essential Responsibilities Manages workers compensation claims determining compensability and benefits due on long‑term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency. Develops and manages workers compensation claims action plans to resolution, coordinates return‑to‑work efforts, and approves claim payments. Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract. Manages subrogation of claims and negotiates settlements. Communicates claim action with claimant and client. Qualifications 4 years of claims management experience or equivalent combination of education and experience. High School Diploma or GED required; Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. SIP required or must be obtained within one (1) year of employment; California workers compensation jurisdictional knowledge required. Benefits Flexible work schedule. Referral incentive program. Career development and promotional growth opportunities. Diverse and comprehensive benefits: medical, dental, vision, 401(k) (on day one), PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other voluntary benefits. Pay range for this role: $75,000 – $85,000 (subject to factors such as skill set, experience, and location). Equal Opportunity Employer 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 Sedgwick Claims Management Services