Sedgwick

Claims Examiner - Workers Compensation (Hybrid - Ontario, CA)

Sedgwick$80K — $90K *
Finance & Insurance
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • 5 years of claims management experience or equivalent combination of education and experience required.
  • High School Diploma or GED required; Bachelor's degree preferred.
  • Professional certification preferred, relevant to the line of business.
  • California workers' compensation claims experience required; SIP preferred.
  • Strong negotiation and communication skills are essential.

Responsibilities

  • Analyze and process claims with action plans for timely resolution.
  • Negotiate claim settlements within designated authority.
  • Communicate claim activity effectively with claimants and clients.
  • Report claims to excess carriers and respond to inquiry requests in a timely manner.
  • Ensure ongoing claims adjudication meets service expectations and best practices.

Benefits

  • Flexible work schedule.
  • Referral incentive program.
  • Career development and promotional growth opportunities.
  • Diverse and comprehensive benefits including medical, dental, vision, and 401K from day one.
Full Job Description
Claims Examiner - Workers Compensation (Hybrid - Ontario, CA)

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?

  • Apply your 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.


ARE YOU AN IDEAL CANDIDATE? We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

OFFICE LOCATIONS
Ontario, California

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.

ESSENTIAL RESPONSIBLITIES 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.


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 experience required | SIP Preferred

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.


As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. 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. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $80,000-$90,000/yr. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

#claimsexaminer #claims #hybrid

About Sedgwick

Sedgwick is a global provider of insurance, risk management, and related services. The company was founded in 1969 and is headquartered in Boston, Massachusetts. Sedgwick offers a range of services to clients in various industries, including property and casualty insurance, workers' compensation, and disability management. The company has a team of experienced professionals who work closely with clients to develop customized solutions that meet their specific needs. Sedgwick has a reputation for delivering high-quality service and has been recognized for its excellence in the insurance industry.
Learn more about Sedgwick
Size
10,000 employees
Industry
Founded
1969

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