Claims Examiner- Workers Compensation | Brea, CA (Hybrid)

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
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.