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Sedgwick

Workers Compensation Claims Examiner

Sedgwick

. Analyze and process complex or technically difficult California workers' compensation claims .

Posted 9/25/2026full-timeRemote • California • United StatesMid-LevelSenior💰 $85,000 - $110,000 per yearWebsite

About the role

Key responsibilities & impact
  • Analyze and process complex or technically difficult California workers' compensation claims
  • Investigate and gather information to determine claim exposure
  • Manage claims through action plans to appropriate and timely resolution
  • Negotiate claim settlements within designated authority
  • Calculate and assign timely and appropriate reserves
  • Manage reserve adequacy throughout the life of claims
  • Calculate and pay benefits due; approve and make claim payments and adjustments
  • Settle claims within designated authority levels
  • Prepare necessary state filings within statutory limits
  • Manage the litigation process and ensure timely, cost-effective claims resolution
  • Report claims to the excess carrier and respond to requests for direction
  • Identify subrogation of claims and negotiate settlements

Requirements

What you’ll need
  • Bachelor's degree from an accredited college or university preferred
  • Professional certification as applicable to line of business preferred
  • Four (4) 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 year of hire date
  • Experience handling litigated and high-exposure claims
  • Ability to manage claims through investigation, benefit determination, settlement negotiation, and resolution
  • Clear and conceptual thinking ability
  • 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 coverage
  • 401(k) and matching
  • Paid time off (PTO)
  • Disability and life insurance
  • Employee assistance program
  • Flexible spending account or health savings account
  • Other additional voluntary benefits
  • Reasonable accommodations when applicable and appropriate