Future Medical Claims Examiner | Brea, CA

Workers' Compensation Claims Careers - Representative, Examiner & Team Leads

Las Vegas, NV
✓ Verified live on the employer's own system · added 18 days ago
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Senior · 6+ yrs exp

Requirements

Experience: 6+ years

Skills & tools

Team LeadershipManagementHiringLitigation

Benefits — mentioned in this posting

Health, dental & vision401(k) / retirement
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Full job description

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

Workers’ Compensation Claims Careers – Representative, Examiner & Team Leads

Sedgwick is growing! As we are building a pipeline of talented claims professionals across multiple career levels—from entry-level Claims Assistants to experienced Claims Examiners and supervisory positions. This is an exciting opportunity to join a growing team and play a key role in delivering high-quality claims service for a new client partnership.

We are hiring across several levels. Placement will be determined based on your experience, skills, and career progression:

  • Process low-level workers’ compensation claims to determine benefits due; ensure ongoing adjudication within company standards and industry best practices; identify subrogation opportunities; and negotiate settlements with general supervision. Review coverage, assess damages, and determine liability within authority limits.
  • Two (2) years of workers’ compensation claims management experience
  • Analyze complex or technically difficult workers’ compensation claims to determine benefits due. Handle high-exposure claims involving litigation and rehabilitation. Ensure ongoing adjudication within service expectations, industry best practices, and specific client requirements. Identify subrogation opportunities and negotiate settlements. Conduct in-depth investigations and make coverage determinations.
  • Five (5) years of workers’ compensation claims management experience
  • Supervise multiple teams of examiners and technical staff. Monitor workloads, provide training, and oversee individual claim activities. Offer technical and jurisdictional guidance on claims adjudication. Maintain diaries for team claims, including frequent updates on complex or high-exposure cases.
  • Six (6) years of claims experience, including two (2) years in a supervisory role
  • Comprehensive benefits package, including medical, dental, vision, and a 401(k) starting on day one

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

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