Workers Compensation Claims Examiner

Sedgwick

Claims Examiner responsible for analyzing workers' compensation claims for clients at Sedgwick. Determining benefits due and ensuring compliance with service expectations in a hybrid work environment.

Posted 5/20/2026full-timeBrea • California • 🇺🇸 United StatesMid-LevelSenior💰 $80,000 - $100,000 per yearWebsite

About the role

Key responsibilities & impact

Analyze workers' compensation claims on behalf of our valued clients to determine benefits due.
Ensure ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
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

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.
California workers' compensation claims experience required | SIP Preferred

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

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Hard Skills & Tools

claims managementworkers' compensation claims analysisnegotiationadjudicationsettlement negotiationinvestigationaction plan developmentreporting

Soft Skills

communicationprofessionalismtimeliness

Certifications

professional certification