Workers Compensation Claims Examiner

1 month ago

Toronto, Ontario, Canada Sedgwick Full time
About Sedgwick

Sedgwick is a global industry leader in claims management and workers' compensation services. We're committed to delivering exceptional customer experiences and making a positive impact on the world through the people and organizations we serve.

Job Summary

We're seeking a skilled Workers Compensation Claims Handler to join our team in California. As a Claims Handler, you'll play a critical role in analyzing and processing claims to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.

Key Responsibilities
  • Analyze and process claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
  • Report claims to the excess carrier and respond to requests for directions in a professional and timely manner.
  • Manage claim recoveries if applicable.
  • Negotiate settlement of claims within designated authority.
  • Refer cases as appropriate to supervisor and management.
  • Calculate and assign timely and appropriate reserves to claims.
  • Ensure claim files are properly documented and claims coding is correct.
  • Communicate claim activity and processing with the claimant and the client.
Qualifications and Licensing

We're looking for candidates with a strong background in claims handling and a passion for delivering exceptional customer experiences. The ideal candidate will have:

  • 4+ years of experience as a Claims Adjuster and Examiner, or 6+ years of experience as a Claims Team Lead with 2+ years of supervisory experience.
  • California jurisdiction experience and licensed to handle claims in the state of CA.
What We Offer

We're committed to taking care of our employees and providing a supportive and inclusive work environment. As a Sedgwick employee, you'll enjoy:

  • Flexible work schedule
  • Referral incentive program
  • Career development and promotional growth opportunities
  • A diverse and comprehensive benefits offering, including medical, dental, vision, and 401K on day 1

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. We're committed to building a diverse, equitable, and inclusive workplace and recognize that each person possesses a unique combination of skills, knowledge, and experience. If you're excited about this role but your experience doesn't align perfectly with every qualification, consider applying anyway. We're looking for talented individuals who share our passion for delivering exceptional customer experiences and making a positive impact on the world.

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