Claims Examiner - Workers Compensation (Dedicated Client)

About the role

Sedgwick is hiring a Claims Examiner for workers' compensation claims on a dedicated client in Brea, CA. The role analyzes complex or technically difficult claims to determine benefits due, works with high-exposure claims involving litigation and rehabilitation, keeps adjudication within service expectations and client requirements, identifies subrogation and negotiates settlements. The office is hybrid: 2 days onsite and 3 days remote.

Key responsibilities

• Analyze and process claims through action plans, investigating and gathering information to determine claim exposure.
• 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 direction professionally and on time.

Required profile

• High school diploma or GED required; bachelor's degree from an accredited college or university preferred.
• Five years of claims management experience or an equivalent combination of education and experience.
• California jurisdictional knowledge required; SIP required.
• Credit security clearance confirmed via a background credit check is required.

Required skills

• Computer keyboarding.
• Travel as required.

What we offer

• Flexible work schedule and referral incentive program.
• Career development and promotional growth opportunities.
• Medical, dental, vision, 401K on day one, PTO, disability and life insurance, and other benefits.
• Starting pay range of $85,000 - $105,000 per year for this role.