Telecommuter CA · Remote
Full-time
Mid level
5 days ago
Apply link not verified recently — we re-check every 2 hours
Salary undisclosed
By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Workers Compensation Claims Examiner Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands? Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. 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. ARE YOU AN IDEAL CANDIDATE? We're looking for a claims professional with California workers' compensation experience who enjoys solving complex problems and delivering outstanding service. The ideal candidate has experience handling litigated and high-exposure claims, understands California jurisdictional requirements, and can confidently manage claims through investigation, benefit determination, settlement negotiation, and resolution. WORK LOCATIONS Must reside in California Role is open to California residents as Hybrid or Remote PRIMARY PURPOSE OF THE ROLE To analyze complex or technically difficult California workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements. ESSENTIAL RESPONSIBLITIES MAY INCLUDE Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution. Negotiates settlement of claims within designated authority. Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim. Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level. Prepares necessary state fillings within statutory limits. Manages the litigation process; ensures timely and cost effective claims resolution. Reporting claims to the excess carrier and responding 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: Three (3) 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. TAKING CARE OF YOU 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. WORK ENVIRONMENT REQUIREMENTS INCLUDE When applicable and appropriate, consideration will be given to reasonable accommodations. Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-rel
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