Claims Examiner - Workers Compensation | Jurisdiction: CA or NV | Licensing: required

About the role

Apply your examiner knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world's most respected organizations. Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. Leverage Sedgwick's broad, global network of experts to both learn from and to share your insights. Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career. Enjoy flexibility and autonomy in your daily work, your location, and your career path. Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

Primary purpose

To analyze workers compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.

Responsibilities

• Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim
• Negotiating settlement of claims within designated authority
• Communicating claim activity and processing with the claimant and the client
• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner

Qualifications

• Education: 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.
• Experience: 5 years of claims management experience or equivalent combination of education and experience required.
• Licensing: Must be licensed in California or Nevada.

Benefits

• Flexible work schedule
• Referral incentive program
• Career development and promotional growth opportunities
• A diverse and comprehensive benefits offering including medical, dental, vision, 401K on day one

Pay

For the jurisdiction noted in this job posting only, the range of starting pay for this role is $80,000-$100,000. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location.