Workers Compensation Claims Examiner

Workers Compensation Claims Examiner 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. Responsibilities Analyze and process claims through well‑developed action plans to reach an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim. Negotiate settlement of claims within designated authority. Communicate claim activity and processing with the claimant and the client. Report claims to the excess carrier and respond to requests for directions in a professional and timely manner. Qualifications Bachelor's degree from an accredited college or university preferred; High School Diploma or GED required. Professional certification as applicable to the line of business preferred. Five (5) years of California Workers Compensation claims management experience or equivalent combination of education and experience required. California jurisdictional knowledge required; SIP required or must be obtained within one (1) year of start 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, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other voluntary benefits. Credit security clearance required, confirmed via a background credit check. EEO Statement Sedgwick is an Equal Opportunity Employer and a Drug‑Free Workplace. #J-18808-Ljbffr Sedgwick Claims Management Services