Workers Compensation Claims Examiner (Dedicated Client) | Rancho Cordova, CA

Posted Yesterday
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Rancho Cordova, CA, USA
In-Office
80K-100K Annually
Senior level
Insurance
Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions.
The Role
Analyze and adjudicate complex California workers' compensation claims, negotiate settlements, communicate with claimants/clients and excess carriers, manage high-exposure claims including litigation and rehabilitation, and ensure timely resolution per client and industry standards.
Summary Generated by Built In

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 (Dedicated Client) | Rancho Cordova, CA

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
Rancho Cordova, 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
    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, travel as required

    Auditory/Visual: Hearing, vision and talking

    NOTE: Credit security clearance, confirmed via a background credit check, is required for this position.

    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 $80,000 - $100,000 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.

    Skills Required

    • Five (5) years of claims management experience or equivalent combination of education and experience
    • High School Diploma or GED
    • Bachelor's degree from an accredited college or university
    • Professional certification applicable to line of business
    • California jurisdictional knowledge
    • SIP required or must be obtained within one (1) year of start date
    • Credit security clearance confirmed via background credit check

    Sedgwick Compensation & Benefits Highlights

    The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Sedgwick and has not been reviewed or approved by Sedgwick.

    • Leave & Time Off Breadth Leave is positioned as a standout part of the package, with generous PTO levels cited (including multi-week starting allotments and higher accrual with tenure). Time-off and flexibility are often framed as meaningful offsets when evaluating the overall rewards mix.
    • Healthcare Strength Healthcare coverage is described as broad, spanning medical, dental, vision, disability/life, and mental-health offerings, with additional wellness and telemedicine-style services. The health suite is frequently characterized as solid, even when not viewed as best-in-class by everyone.
    • Retirement Support Retirement benefits include a 401(k) with employer matching and are grouped with other financial supports like HSA/FSA options. The match is viewed as a helpful baseline benefit, though generally not positioned as unusually rich.

    Sedgwick Insights

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    The Company
    HQ: Memphis, TN
    31,000 Employees
    Year Founded: 1969

    What We Do

    From our modest beginnings as a regional claims administrator, Sedgwick has grown into a leading global provider of technology-enabled risk, benefits and integrated business solutions with 31,000+ colleagues, located across 80 countries. Through innovative product development, organic business development and strategic acquisitions, Sedgwick’s offerings continue to evolve beyond claims processing to meet the current and future needs of our clients. Our approach to delivering quality service in areas such as workers’ compensation, liability, property, disability and absence management goes far beyond just managing claims—we aim to simplify the process and reduce complexity, making it easy and effective for everyone involve.

    Why Work With Us

    We stay tuned into what our colleagues want and need and deliver a world-class colleague experience that demonstrates how much we value their unique contributions to our business. You’ll see and feel what it’s like to work for a company that’s committed to doing the right thing – for those we serve, for our planet and for each other.

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