Claims Examiner - Workers Compensation (On-Site Ontario, CA)

Claims Examiner – Workers Compensation (On‑Site, Ontario, CA) The Claims Examiner – Workers Compensation is responsible for analyzing workers’ compensation claims to determine benefits due, ensuring timely adjudication to meet service expectations and client requirements. Primary Purpose of the role: To analyze Workers Compensation claims on behalf of clients in order to determine benefits due, while maintaining ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements. Essential Responsibilities Analyze and process claims through well‑developed action plans to an appropriate and timely resolution, 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 of directions in a professional and timely manner. Qualifications 3 years of claims management experience or equivalent combination of education and experience required. 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. 3 or more years of California workers compensation jurisdiction knowledge required; SIP required or must be obtained within one (1) year of employment. Work Environment Requirements Physical: Computer keyboarding. Auditory/Visual: Hearing, vision and talking. 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. Taking Care of You 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. Equal Employment 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 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. #J-18808-Ljbffr Hispanic Alliance for Career Enhancement