Costa Mesa, CA Van Nuys, CA

Sacramento, CA - National

Full time

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Remote Workers Compensation Claims Examiner | CA Jurisdiction

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?

California workers' compensation claims experience required. We're looking claim's professionals with California workers' compensation experience who enjoy solving complex problems and delivering outstanding service. The ideal candidate has experience handling litigated and high-exposure claims, understands California jurisdictional requirements, and can confidently manage claims through investigation, benefit determination, settlement negotiation, and resolution.

To analyze complex or technically difficult California 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.

Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution. Negotiates settlement of claims within designated authority. Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.



approves and makes timely claim payments and adjustments; Manages the litigation process; ensures timely and cost effective claims resolution.

Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner. Bachelor's degree from an accredited college or university preferred. Three (3) years of California workers compensation claims management experience or equivalent combination of education and experience required.

Flexible work schedule. A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one. excellent judgment, troubleshooting, problem solving, analysis, and discretion; Computer keyboarding 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.

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Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company’s expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, perks administration, and product recall.

With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape.

📌 Remote Workers Compensation Claims Examiner | CA Jurisdiction (Canada)
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📍 Canada