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.
We're looking for an experienced California workers' compensation professional with strong leadership, technical claims expertise, and a client-focused approach to managing complex and high-exposure claims.
Primary Purpose of the Role: Oversees a team of examiners and technical staff handling workers compensation claims for a dedicated client. Manages workloads, provides training, and monitors individual claim activities. Offers technical and jurisdictional guidance on claims adjudication and maintains regular diaries, especially for complex or high-exposure cases.
Essential Responsibilities May Include
- Supervises a team of examiners and technical operations colleagues, delegating duties as needed and ensuring proper licensing and documentation standards.
- Provides technical and jurisdictional guidance on claims adjudication, including quality reviews and reserve evaluations for high-cost or complex claims.
- Acts as a second-level appeal authority for client and claimant issues, implementing final decisions.
- Identifies trends, issues, and opportunities for process improvement; advises management and coordinates related projects.
- Monitors third-party and sensitive claims, including litigated and vocational rehabilitation cases.
- Maintains professional client relationships, offering recommendations and written summaries as needed.
- Ensures accurate claim coding and documentation by examiners.
Qualifications
- Education & Licensing: 6 years of claims experience or equivalent combination of education and experience preferred.
- 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 workers compensation claim handling experience required | SIP Certified
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.
The range of starting pay for this role is $105,000-$118,000/yr. 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.