Claims Examiner – Workers Compensation | Jurisdiction: CA or NV | Licensing: required JD Advantage

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 examiner 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.  

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: 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. 

Experience: 5 years of claims management experience or equivalent combination of education and experience required. 

Licensing / Jurisdiction Knowledge: Must be licensed in California or Nevada

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. 

WORK ENVIRONMENT REQUIREMENTS INCLUDE  
When applicable and appropriate, consideration will be given to reasonable accommodations. 

Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines 

Physical: Computer keyboarding

Auditory/Visual: Hearing, vision and talking 

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 (80k-100k). 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 #LI-REMOTE