Workers Compensation Claims Examiner

About the role

Join Sedgwick, a global industry leader recognized by Fortune and Newsweek, to solve complex problems and deliver outstanding service to some of the world’s best brands. Our dynamic culture offers opportunities for personal and professional growth.

Responsibilities

• Analyze complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim.
• Manage claims through well-developed action plans to an appropriate and timely resolution.
• Negotiate settlement of claims within designated authority.
• Calculate and assign timely and appropriate reserves to claims; manage reserve adequacy throughout the life of the claim.
• Calculate and pay benefits due; approve and make timely claim payments and adjustments; settle claims within designated authority level.
• Prepare necessary state filings within statutory limits.
• Manage the litigation process; ensure timely and cost-effective claims resolution.
• Report claims to the excess carrier and respond to requests of directions in a professional and timely manner.

Qualifications

• Education & Licensing: Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred.
• Experience: Four (4) years of California workers compensation claims management experience or equivalent combination of education and experience required.
• Licensing / Jurisdiction Knowledge: California jurisdictional knowledge required; SIP required or must be obtained within one year of hire date.