Sedgwick Logo

Sedgwick

Workers Compensation Claims Examiner | Brea, CA | Sign-On Bonus Eligible

Reposted 22 Days Ago
Be an Early Applicant
In-Office
Brea, CA, USA
85K-105K Annually
Senior level
In-Office
Brea, CA, USA
85K-105K Annually
Senior level
Adjudicate complex California workers' compensation claims by investigating exposures, negotiating settlements, communicating with claimants/clients, reporting to excess carriers, identifying subrogation, and managing litigation and rehabilitation matters while meeting client service and industry standards.
The summary above was generated by AI

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve.

Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies

Certified as a Great Place to Work®

Fortune Best Workplaces in Financial Services & Insurance

Workers Compensation Claims Examiner | Brea, CA | Sign-On Bonus Eligible

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 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.

OFFICE LOCATIONS
Brea, CA - Hybrid (2 days onsite)
 

PRIMARY PURPOSE: 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; and to identify subrogation of claims and negotiate settlements.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

  • 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
    Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred.

    Experience
    Five (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.

    Licensing / Jurisdiction Knowledge: California jurisdictional knowledge required; SIP required or must be obtained within one (1) year of start date.

    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 $85,000 - $105,000 per year. 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.

    #Claims #ClaimsExaminer #Hybrid #LI-Hybrid #LI-Remote #LI-AM1
     

    Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance, the San Diego Fair Chance Ordinance, the San Francisco Fair Chance Ordinance, the California Fair Chance Act, and all other applicable laws.

    Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

    If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

    Similar Jobs

    4 Days Ago
    In-Office or Remote
    USA
    73K-113K Annually
    Senior level
    73K-113K Annually
    Senior level
    Insurance
    Supervise a team of workers' compensation claims examiners, ensure compliance with WC laws and regulatory reporting, provide technical/jurisdictional guidance, coach and evaluate staff, assist with hiring/onboarding, participate in client claim reviews, and recommend claim resolutions. Must maintain WC certification and Washington claims experience.
    Top Skills: ExcelMS Office
    20 Minutes Ago
    In-Office or Remote
    United States
    215K-358K Annually
    Senior level
    215K-358K Annually
    Senior level
    Artificial Intelligence • Healthtech • Machine Learning • Natural Language Processing • Biotech • Pharmaceutical
    Lead scientific and strategic AI efforts for Vaccines Medical: define AI vision and roadmap, govern responsible AI standards, prioritize and deliver validated AI-enabled solutions, partner cross-functionally, oversee deployment and adoption, manage budget and vendors, and ensure regulatory, ethical, and scientific compliance across global medical affairs.
    Top Skills: Advanced AnalyticsGenerative AiLarge Language ModelsMachine LearningNatural Language Processing
    20 Minutes Ago
    In-Office
    La Jolla, CA, USA
    177K-294K Annually
    Senior level
    177K-294K Annually
    Senior level
    Artificial Intelligence • Healthtech • Machine Learning • Natural Language Processing • Biotech • Pharmaceutical
    Lead Oncology AI product strategy and a cross-functional AI engineering team to translate scientific needs into scalable AI solutions across discovery, clinical development, and real-world evidence. Define roadmaps, governance, success metrics, stakeholder engagement, and adoption to move AI initiatives from pilots to sustained impact.

    What you need to know about the Los Angeles Tech Scene

    Los Angeles is a global leader in entertainment, so it’s no surprise that many of the biggest players in streaming, digital media and game development call the city home. But the city boasts plenty of non-entertainment innovation as well, with tech companies spanning verticals like AI, fintech, e-commerce and biotech. With major universities like Caltech, UCLA, USC and the nearby UC Irvine, the city has a steady supply of top-flight tech and engineering talent — not counting the graduates flocking to Los Angeles from across the world to enjoy its beaches, culture and year-round temperate climate.

    Key Facts About Los Angeles Tech

    • Number of Tech Workers: 375,800; 5.5% of overall workforce (2024 CompTIA survey)
    • Major Tech Employers: Snap, Netflix, SpaceX, Disney, Google
    • Key Industries: Artificial intelligence, adtech, media, software, game development
    • Funding Landscape: $11.6 billion in venture capital funding in 2024 (Pitchbook)
    • Notable Investors: Strong Ventures, Fifth Wall, Upfront Ventures, Mucker Capital, Kittyhawk Ventures
    • Research Centers and Universities: California Institute of Technology, UCLA, University of Southern California, UC Irvine, Pepperdine, California Institute for Immunology and Immunotherapy, Center for Quantum Science and Engineering

    Sign up now Access later

    Create Free Account

    Please log in or sign up to report this job.

    Create Free Account