Workers Compensation Claims Examiner

Sedgwick

. Analyze and process workers compensation claims through action plans to achieve appropriate and timely resolution .

Posted 11/10/2026full-timeRemote • California • United StatesMid-LevelSenior💰 $85,000 - $105,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in analyzing and processing workers compensation claims, with strong negotiation skills and the ability to deliver customer-facing solutions. Possesses California workers compensation jurisdictional knowledge and the ability to manage multiple priorities effectively.

Highest-signal resume keywords

Claims Management ExperienceCalifornia Workers Compensation KnowledgeNegotiation SkillsSIP CertificationProblem-Solving Ability

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims AnalysisClaims ProcessingNegotiationAdjudicationCustomer-Facing Solutions

Soft Skills

Excellent JudgmentTroubleshootingDiscretionAbility to Handle Work-Related StressAbility to Meet Deadlines

Tools & Technologies

Computer Keyboarding

Certifications & Qualifications

SIP CertificationProfessional Certification

Industry Keywords

Workers Compensation ClaimsClaim ExposureClaim SettlementsExcess Carrier Reporting

About the role

Key responsibilities & impact

Analyze and process workers compensation claims through action plans to achieve appropriate and timely resolution
Investigate and gather information to determine claim exposure
Negotiate claim settlements within designated authority
Communicate claim activity and processing with claimants and clients
Report claims to the excess carrier
Respond professionally and promptly to requests for directions
Adjudicate complex workers compensation claims on behalf of clients
Deliver customer-facing solutions to clients across industries

Requirements

What you’ll need

4 years of claims management experience or equivalent combination of education and experience required
High School Diploma or GED required
California workers compensation jurisdictional knowledge required
SIP required or must be obtained within one year of employment
Bachelor's degree from an accredited college or university preferred
Professional certification as applicable to line of business preferred
Ability to analyze and process workers compensation claims
Negotiation skills for claim settlements within designated authority
Excellent judgment, troubleshooting, problem-solving, analysis, and discretion
Ability to handle work-related stress and multiple priorities simultaneously
Ability to meet deadlines
Computer keyboarding ability
Hearing, vision, and talking abilities

Benefits

Comp & perks

Flexible work schedule
Referral incentive program
Career development and promotional growth opportunities
Medical, dental, and vision benefits on day one
401(k) on day one
401(k) matching
Paid time off (PTO)
Disability insurance
Life insurance
Employee assistance program
Flexible spending or health savings account
Additional voluntary benefits
Remote work flexibility and autonomy