Hiring: Claims Examiner - Workers Comp (Hybird Roseville, CA) Company: Sedgwick Location: Roseville, CA Job Posted Time: 2026-09-17 10:17:07 About the job Experience: •Five (5) years of claims management experience or equivalent combination of education and experience required. •Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business. •Excellent oral and written communication, including presentation skills •PC literate, including Microsoft Office products Required Skills: •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. Compensation: •Flexible work environment (work from home / hybrid options) •Competitive benefits and rewards package Interested candidates, please apply directly through the job posting on company's career page or try via AI auto apply on this platform. Don't miss this opportunity to join a forward-thinking team!