{"id":1275881,"url":"https://alion.io/job/sedgwick-workers-compensation-claims-examiner-3","title":"Workers Compensation Claims Examiner","company":{"id":5707,"name":"Sedgwick","domain":"sedgwick.com","url":"https://alion.io/company/sedgwick","size_band":"5000+","is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"Workday","truth_index":{"grade":"A","score":86,"open_postings":48,"ghost_share":0,"stale_share":0.708,"repost_share":0.063,"time_to_fill_p50_days":20,"computed_at":"2026-10-17T05:46:00Z"}},"role":"HR","role_family":"HR","seniority":"middle","employment_type":"full_time","work_mode":"remote","remote_scope":"stated_countries","remote_scope_basis":"board_field","remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["United States"],"countries":["US"],"hiring_countries":["US"],"hiring_countries_total":1,"salary":{"min":85000,"max":110000,"currency":"USD","period":"year","gross":null,"usd_annual":110000},"salary_estimate":null,"experience_years_min":4,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[],"status":"live","first_seen_at":"2026-09-25T00:00:00Z","employer_posted_date":"2026-09-25","last_verified_at":"2026-10-18T01:42:24Z","board_verified":true,"closed_at":null,"days_open":23,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":23},"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.\nNewsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies\nCertified as a Great Place to Work®\nFortune Best Workplaces in Financial Services & Insurance\nWorkers Compensation Claims ExaminerAre 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?\nApply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. \nDeliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations. \nBe a part of a rapidly growing, industry-leading global company known for its excellence and customer service. \nLeverage Sedgwick’s broad, global network of experts to both learn from and to share your insights. \nTake advantage of a variety of professional development opportunities that help you perform your best work and grow your career. \nEnjoy flexibility and autonomy in your daily work, your location, and your career path. \nAccess diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs. \nARE YOU AN IDEAL CANDIDATE? We're looking for a claims professional with California workers' compensation experience who enjoys solving complex problems and delivering outstanding service. The ideal candidate has experience handling litigated and high-exposure claims, understands California jurisdictional requirements, and can confidently manage claims through investigation, benefit determination, settlement negotiation, and resolution.\nPRIMARY PURPOSE OF THE ROLE To analyze complex or technically difficult California 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.\nESSENTIAL RESPONSIBLITIES MAY INCLUDE\nAnalyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.\nNegotiates settlement of claims within designated authority.\nCalculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.\nCalculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.\nPrepares necessary state fillings within statutory limits.\nManages the litigation process; ensures timely and cost effective claims resolution.\nReporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.\nQUALIFICATIONS\nEducation & Licensing: Bachelor's degreefrom an accredited college or university preferred. Professional certification as applicable to line of business preferred.\nExperience: Four (4) years of California workers compensation claims management experience or equivalent combination of education and experience required.\nLicensing / Jurisdiction Knowledge: California jurisdictional knowledge required; SIP required or must be obtained within one year of hire date.\nTAKING CARE OF YOU\nFlexible work schedule. \nReferral incentive program. \nCareer development and promotional growth opportunities. \nA diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.\nWORK ENVIRONMENT REQUIREMENTS INCLUDE\nWhen applicable and appropriate, consideration will be given to reasonable accommodations.\nMental: 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\nPhysical: Computerkeyboarding\nAuditory/Visual: Hearing, vision and talking\nAs 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 $85,000 - $110,000. 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.\n#Claims #ClaimsExaminer #LI-Remote\nQualified 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.\nSedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.\nIf 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.","description_format":"text","description_chars":5992,"description_truncated":false,"requirements":{"experience_years_min":4,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":{"level":"bachelor","optional":false},"security_clearance":false,"languages":[]},"benefits":["401k plan","Flexible schedule","Growth opportunities","Life insurance","Professional development"],"hiring_locations":[{"name":"United States","iso":"US","kind":"country"}],"hiring_excludes":[],"relocation_offered":false,"industries":["Business Process Outsourcing (BPO)","Insurance Brokers & Agencies"],"lifecycle":[{"event":"open","at":"2026-09-26T01:31:22Z"}],"visa":[],"liveness":{"score":29,"band":"fade","label":"Fading","p_open":1,"p_active":0.519,"p_room":0.55,"age_days":22,"expected_fill_days":20,"reasons":["conf:3","stale_co","velocity","win:tail","comp:brand"],"computed_at":"2026-10-17T05:46:00Z"},"pay":{"stated_usd_annual":110000,"is_top_pay":true},"html_url":"https://alion.io/job/sedgwick-workers-compensation-claims-examiner-3","json_url":"https://alion.io/job/sedgwick-workers-compensation-claims-examiner-3.json","meta":{"generated_at":"2026-10-18T16:38:52Z","cache_seconds":300,"methodology":"https://alion.io/methodology","terms":"https://alion.io/terms","contact":"https://alion.io/contact","api":"https://alion.io/developers","about":"Alion is a live layer of people, companies and AI agents: who they are, whether they are real and active right now, what they do and how to work with them, readable by people and by agents and paid per call.","catalog":"https://alion.io/catalog.json","usage":{"tier":"crawler_verified","counted_by":"address","units_charged":1,"used_today":22205,"day_limit":null,"remaining_today":null,"minute_limit":300,"resets_at":"2026-10-19T00:00:00Z"}},"offers":[{"id":"company.slices","title":"One company in depth, by slice","status":"live","price":{"credits":0.02,"usd":0.002,"plus_per_slice":{"credits":0.05,"usd":0.005}},"unit":"per company, plus each slice with data","note":"the employer in depth","call":{"mcp_tool":"get_company","arguments":{"id":5707},"rest":"https://alion.io/mcp/rest/get_company?id=5707"},"human":"https://alion.io/catalog?offer=company.slices&for=job%2Fsedgwick-workers-compensation-claims-examiner-3"},{"id":"market.stats","title":"A market slice: pay, demand and time to fill","status":"live","price":{"credits":1,"usd":0.1},"unit":"per slice","note":"pay, demand and time to fill for this role and place","call":{"mcp_tool":"market_stats"},"human":"https://alion.io/catalog?offer=market.stats&for=job%2Fsedgwick-workers-compensation-claims-examiner-3"},{"id":"job.search","title":"Open jobs by role, technology, place, pay and visa","status":"live","price":{"credits":0.02,"usd":0.002},"unit":"per posting in a list","note":"similar open postings","call":{"mcp_tool":"search_jobs"},"human":"https://alion.io/catalog?offer=job.search&for=job%2Fsedgwick-workers-compensation-claims-examiner-3"},{"id":"company.verify","title":"Is this company real and active right now","status":"pilot","price":null,"unit":"per company","request":{"url":"https://alion.io/catalog/request","method":"POST","body":"{\"offer\": \"company.verify\", \"for\": \"job/sedgwick-workers-compensation-claims-examiner-3\", \"note\": \"what you need it for\"}"},"human":"https://alion.io/catalog?offer=company.verify&for=job%2Fsedgwick-workers-compensation-claims-examiner-3"}]}