Workers Compensation Claims Examiner
Sedgwick
full-time
Posted on:
Location Type: Hybrid
Location: San Diego • California • 🇺🇸 United States
Visit company websiteSalary
💰 $80,000 - $100,000 per year
Job Level
Mid-LevelSenior
About the role
- To 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 claims through well-developed action plans to an appropriate and timely resolution.
- Negotiate settlement of claims within designated authority.
- Calculate and pay benefits due; approve and make timely claim payments and adjustments.
Requirements
- 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.
- SIP required or must be obtained within one (1) year of employment; California workers compensation jurisdictional knowledge required.
Benefits
- 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.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
claims managementnegotiationsettlement calculationadjudicationsubrogation
Soft skills
analytical skillscommunicationproblem-solvingtime management
Certifications
SIPBachelor's degree