Top 17 Claims examiner Jobs in Roseville Ca

Workers Compensation Claims Examiner | Dedicated Account | 3 Days Remote
Sedgwick —Roseville, CA
- Hybrid work
- 5 years
- Office
- Bachelor's degree
- Health savings account
- Disability insurance
Workers Compensation Claims Examiner | CA Claims Exp. Required
Sedgwick —Roseville, CA
- Hybrid work
- Mid-level
- High school diploma or GED
- Bachelor's degree
- Health savings account
- Disability insurance
Workers Compensation Claims Examiner | Long Beach or Roseville, CA (Hybrid)
Sedgwick —Roseville, CA
- Full-time
- Hybrid work
- Mid-level
- High school diploma or GED
- Bachelor's degree
- Health savings account
- Disability insurance
5d
Workers Compensation Claims Examiner | Roseville, CA
Sedgwick —Roseville, CA
- Hybrid work
- Customer service
- Bachelor's degree
- Fair chance
- Health savings account
- Disability insurance
6d
Claims Examiner - Workers Comp (Hybird Roseville, CA)
Sedgwick —Roseville, CA
- 5 years
- Computer literacy
- Writing skills
- Health savings account
- Disability insurance
Claims Examiner - Auto Liability - Commercial Trucking
Sedgwick —Roseville, CA
- Full-time
- Hybrid work
- 5 years
- Mid-level
- Bachelor's degree
- Health savings account
- Disability insurance
5d
Sr Claim Examiner-WC (CA)
Broadspire Services, Inc. —Folsom, CA
- Full-time
- Hybrid work
- Analysis skills
- Bachelor's degree
- Mentoring
- Paid parental leave
- Health savings account
Quick Apply
Examiner Physician Assistant - Travel
Loyal Source Government Services —California
- $133,120 - $163,120 a year
- Microsoft Word
- Microsoft Outlook
- Military
Quick Apply
Examiner Physician Assistant
Loyal Source Government Services —Rocklin, CA
- $64.69 an hour
- Monday to Friday
- Microsoft Word
- Microsoft Outlook
- Military
Quick Apply
Examiner Nurse Practitioner
Loyal Source Government Services —Rocklin, CA
- $149,572 - $179,572 a year
- Monday to Friday
- Microsoft Word
- Nursing
- Microsoft Outlook
Quick Apply
Appeals Examiner - West Sacramento, CA
Gainwell Technologies —West Sacramento, CA
- $37,500 - $53,500 a year
- Full-time
- Microsoft Excel
- Microsoft Outlook
- HIPAA
- Travel reimbursement
- Profit sharing

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Workers Compensation Claims Examiner | CA Claims Exp. Required
Sedgwick —Roseville, CA
Professional certification as applicable to line of business preferred. Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting,…
Claims Team Lead - Workers Compensation | CA Claims Exp. Required
Sedgwick —Roseville, CA
PRIMARY PURPOSE: To supervise the operation of a team of workers compensation claims examiners and technical staff for workers compensation claims for clients;…
9d

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Account Examiner 2 - (PN: 20067987)
State of Ohio - Workers' Compensation —Columbus, OH
Provide customer service by handling Other States Coverage phone calls and emails regarding program requirements, assisting with Acord forms, creating…
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claims examiner jobs near roseville ca

Workers Compensation Claims Examiner | Dedicated Account | 3 Days Remote

Sedgwick -
Roseville, CA

Apply Now

Job Details

Benefits

Health savings account
Disability insurance
Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance
401(k) matching
Flexible schedule
Life insurance
Referral program

Qualifications

Customer communication

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

Certified as a Great Place to Work®

Fortune Best Workplaces in Financial Services & Insurance

Workers Compensation Claims Examiner | San Diego or Roseville, CA

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
Roseville, CA (Hybrid - 2 days in office)

San Diego, CA (Hybrid - 2 days in office)

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

Analyzes 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.
Negotiates settlement of claims within designated authority.
Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.
Prepares necessary state fillings within statutory limits.
Manages the litigation process; ensures timely and cost effective claims resolution.
Coordinates vendor referrals for additional investigation and/or litigation management.
Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.
Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.
Ensures claim files are properly documented and claims coding is correct.
Refers cases as appropriate to supervisor and management.

QUALIFICATION

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.

Licensing / Jurisdiction Knowledge: California jurisdictional knowledge required; SIP required or must be obtained within one (1) year of employment.

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.

As 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 80,000 - 100,000 . 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.

#Claims #ClaimsExaminer #Hybrid #LI-Hybrid #LI-Remote #LI-AM1

Qualified 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.

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

If 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.

Apply Now

Refine Your Search

claims examiner jobs in roseville ca

Workers Compensation Claims Examiner | Dedicated Account | 3 Days Remote

Workers Compensation Claims Examiner | CA Claims Exp. Required

Workers Compensation Claims Examiner | Long Beach or Roseville, CA (Hybrid)

Workers Compensation Claims Examiner | Roseville, CA

Claims Examiner - Workers Comp (Hybird Roseville, CA)

Claims Examiner - Auto Liability - Commercial Trucking

Sr Claim Examiner-WC (CA)

Examiner Physician Assistant - Travel

Examiner Physician Assistant

Examiner Nurse Practitioner

Appeals Examiner - West Sacramento, CA

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