Workers Compensation Claims Adjuster | Remote - CA Resident

PRIMARY PURPOSE OF THE ROLE:

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.

• May Include
• 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.

About the Role

Join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands. Leverage Sedgwick’s broad, global network of experts to both learn from and to share your insights.

Responsibilities

• Analyze and process claims through well-developed action plans to an appropriate and timely resolution.
• Investigate and gather information to determine the exposure on the claim.
• 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 of directions professionally and timely.

Qualifications

• Education & Licensing: 5 years of claims management experience or equivalent combination of education and experience required. 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.
• Licensing / Jurisdiction Knowledge: California workers' compensation claims handling experience | SIP certified preferred.

Benefits

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.

• A flexible work schedule.
• Referral incentive program.
• Career development and promotional growth opportunities.
• A comprehensive benefits package including medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

Work Environment Requirements

• Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines.
• Physical: Computer keyboarding.
• Auditory/Visual: Hearing, vision and talking.