Claims Examiner – Workers Compensation

Sedgwick

Claims Examiner adjudicating complex workers' compensation claims for Sedgwick, a global industry leader. Analyzing and negotiating high exposure claims while ensuring excellent customer service.

Posted 5/20/2026full-timeBrea • California • 🇺🇸 United StatesMid-LevelSenior💰 $85,000 - $105,000 per yearWebsite

About the role

Key responsibilities & impact

To analyze complex or technically difficult 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.
To identify subrogation of claims and negotiate settlements.
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.

Requirements

What you’ll need

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.
High School Diploma or GED required.
California jurisdictional knowledge required; SIP required or must be obtained within one (1) year of start date.

Benefits

Comp & perks

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.

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

claims managementnegotiationsubrogationadjudicationsettlement processinginvestigationaction planninglitigationrehabilitation

Soft Skills

communicationanalytical thinkingproblem-solvingtime management

Certifications

SIP