Claims Examiner - Workers Compensation | Rancho Cordova, CA

About the role

Join Sedgwick, a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands. This role offers an energetic culture, rapid growth, and access to diverse and comprehensive benefits.

Responsibilities

• Analyze complex or technically difficult workers' compensation claims to determine benefits due
• Work with high exposure claims involving litigation and rehabilitation
• Ensure ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements
• Identify subrogation of claims and negotiate settlements
• Manage the litigation process to ensure timely and cost-effective claims resolution
• Coordinate vendor referrals for additional investigation and/or litigation management
• Leverage strategic vendor partnerships to reduce overall cost of claims for clients
• Manage claim recoveries, including subrogation, Second Injury Fund excess recoveries, and Social Security and Medicare offsets
• Report claims to the excess carrier and respond to requests in a professional and timely manner
• Communicate claim activity and processing with the claimant and the client, maintaining professional client relationships
• Maintain proper documentation and correct claims coding
• Refer cases as appropriate to supervisor and management

Qualifications

• Bachelor's degree from an accredited college or university preferred
• Professional certification as applicable to line of business preferred
• Five (5) years of claims management experience or equivalent combination of education and experience required
• California jurisdictional knowledge required; SIP required or must be obtained within one (1) year of employment

Benefits

• Flexible work schedule
• Referral incentive program
• Career development and promotional growth opportunities
• A diverse and comprehensive benefits offering including medical, dental, vision, 401k, and matching
• Paid time off
• Disability and life insurance
• Employee assistance program
• Flexible spending or health savings account
• Additional voluntary benefits

Pay

The starting pay range for this role is $85,000 - $100,000.

Schedule

This role is available as a hybrid position, working 2 days per week onsite.