Workers Compensation Claims Examiner

Sedgwick

Workers Compensation Claims Examiner analyzing claims for clients in diverse industries. Joining global leader with professional development and comprehensive benefits.

Posted 7/24/2026full-timeRemote • California • 🇺🇸 United StatesMid-LevelSenior💰 $80,000 - $100,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Workers Compensation claims management, including analysis, negotiation, and communication with clients and claimants. Proficient in adhering to industry best practices and service expectations while ensuring timely resolution of claims.

Highest-signal resume keywords

Claims Management ExperienceCalifornia Workers Compensation KnowledgeNegotiation SkillsClient CommunicationProfessional Certification

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims AnalysisClaims ProcessingAdjudicationSettlement NegotiationInformation Gathering

Soft Skills

Professional CommunicationTimely Response

Certifications & Qualifications

Professional Certification

Industry Keywords

Workers CompensationClaims AdjudicationService ExpectationsBest PracticesExcess Carrier Reporting

About the role

Key responsibilities & impact

To analyze Workers Compensation claims on behalf of our valued clients to determine benefits due.
Ensuring 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

4 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 jurisdictional knowledge required.

Benefits

Comp & perks

Flexible work schedule.
Referral incentive program.
Career development and promotional growth opportunities.
Diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.