workers' compensation claims examiner

Sedgwick

<div><p>By joining Sedgwick, you'll be part of something truly meaningful. It&rsquo;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&rsquo;s no limit to what you can achieve.
</p><p></p><p>Newsweek Recognizes Sedgwick as America&rsquo;s Greatest Workplaces National Top Companies
</p><p>Certified as a Great Place to Work&reg;
</p><p>Fortune Best Workplaces in Financial Services &amp; Insurance
</p><p></p>Workers Compensation Claims Examiner | NJ, PA, VA, DE Jurisdictions
<p></p><div><p>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&rsquo;s best brands?
</p><ul><li>Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.
</li><li>Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world&rsquo;s most respected organizations.
</li><li>Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
</li><li>Leverage Sedgwick&rsquo;s broad, global network of experts to both learn from and to share your insights.
</li><li>Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.
</li><li>Enjoy flexibility and autonomy in your daily work, your location, and your career path.
</li><li>Access diverse and comprehensive benefits to take care of your mental, physical, financial, and professional needs.
</li></ul><p></p><p><b>ARE YOU AN IDEAL CANDIDATE? </b>To analyze <b>Lost-Time Workers Compensation ( </b>litigated, subrogation, high exposure/severe cases) claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
</p><p></p><p><b>PRIMARY PURPOSE OF THE ROLE: </b>We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.
</p><p></p><p><b>ESSENTIAL RESPONSIBLITIES MAY INCLUDE
</b></p><ul><li>Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
</li><li>Negotiating settlement of claims within designated authority.
</li><li>Communicating claim activity and processing with the claimant and the client.
</li><li>Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.
</li></ul><p></p><p><b>QUALIFICATIONS
</b></p><ul><li>Education &amp; Licensing: 2-3 years of claims management experience or equivalent combination of education and experience required.
</li><li>High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.
</li><li>Professional certification as applicable to line of business preferred.
</li></ul><p></p><p><b>Jurisdiction Knowledge: NJ, PA, VA, DE
</b></p><p><b>Licensing: DE preferred, not required
</b></p><p></p><p><b>TAKING CARE OF YOU
</b></p><ul><li>Flexible work schedule.
</li><li>Referral incentive program.
</li><li>Opportunity to work in an agile environment.
</li><li>Career development and promotional growth opportunities.
</li></ul><p></p><p>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 (75,000 - 90,000). 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.
</p></div><p></p><p>Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
</p><p></p><h2 class="jobSectionHeader"><b>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.</b></h2></div>

Workers Compensation Claims Examiner | NJ, PA, VA, DE Jurisdictions

Lowe's Home Improvement

<div><p><b>Do your Best Work in Mooresville</b></p><p></p><p>
This position is based at our headquarters in Mooresville, North Carolina. Our corporate office is a space where you can collaborate and do your best work. Take a walk, grab a bite (or a cup of coffee), work out or get a check-up &ndash; we invest in you so you can find your inspiration.</p><p></p><p><b>
Your Impact</b><br>
<br>
The primary purpose of this role is to investigate, evaluate and resolve complex personal injury, product liability and property damage general liability claims against Lowe's and/or its subsidiaries in a manner consistent with the Lowe's objectives and values. This position is responsible for gathering appropriate information, evaluating alleged damages, determining liability and compensability, negotiating settlements, and reporting obtained information.<br>
<br>
<b>What You Will Do</b></p><ul><li><p>
Investigates, evaluates and resolves complex personal injury, product liability, and property damage general liability claims against the Company and/or its subsidiaries in a manner consistent with the Company&rsquo;s objectives and values</p></li><li><p>
Gathers appropriate information, evaluates alleged damages, determining liability and compensability and negotiating settlements and reporting obtained information</p></li><li><p>
Collaborates with other claims examiners on a team, focusing on bodily injury or property damage in a particular jurisdiction, acting as a leader for the team of Claims Examiners by integrating Lowe&rsquo;s culture, team training, and jurisdiction-specific training into the on-boarding process</p></li><li><p>
Conducts investigations of claims by interviewing claimants and witnesses, obtaining official reports, and by comparing claim information with evidence</p></li><li><p>
Serves as an escalation point for Claims Examiners on issues that cannot be satisfactorily resolved by the Claims Examiner, this position investigates complaints made by customers or stores against claims examiners</p></li><li><p>
Maintains a functional knowledge of the relevant laws and legal principles in order to resolve claims</p></li><li><p>
Works consistently with Store Operations, Human Resources, and Loss Prevention to resolve claims in a timely and efficient manner while maintaining adequate production s and while fulfilling reasonable customer service expectations</p></li><li><p>
Prepares reports by collecting and summarizing information as required</p></li><li><p>
Settles claims within his/her authority and in an appropriate manner consistent with Lowe&rsquo;s objectives and values by determining liability, by obtaining demands and making offers to claimants, requesting settlement checks, making filings with regulatory agencies, and disposing of salvage, pursuing subrogation when appropriate</p></li><li><p>
Controls claim costs, provides excellent customer service and resolves complaints to the satisfaction of the customer</p></li><li><p>
Complies with federal and state regulations and service standards</p></li></ul><p><b><br>
Minimum Qualifications</b></p><ul><li><p>
High school diploma or GED or equivalent years of experience in lieu of education requirement, if applicable</p></li><li><p>
6 Years Experience as a Claims Examiner or materially relevant knowledge, skills and abilities from other professions (e.g., loss prevention, customer service, investigative experience, legal experience, property estimating experience)</p></li></ul><p><b><br>
Preferred Skills/Education</b></p><ul><li><p>
Associate degree</p></li><li><p>
Bachelor&rsquo;s degree</p></li><li><p>
Master&rsquo;s degree</p></li><li><p>
4 Years Experience as a Claims Examiner or materially relevant knowledge, skills and abilities from other professions (e.g., loss prevention, customer service, investigative experience, legal experience, property estimating experience)</p></li><li><p>
2 Years Experience as a Claims Examiner or materially relevant knowledge, skills and abilities from other professions (e.g., loss prevention, customer service, investigative experience, legal experience, property estimating experience)</p></li><li><p>
1 Year Experience as a Claims Examiner or materially relevant knowledge, skills and abilities from other professions (e.g., loss prevention, customer service, investigative experience, legal experience, property estimating experience)</p></li><li><p>
Lowe's finance or accounting experience</p></li><li><p>
Relevant professional licenses and/or certifications, including a North Carolina insurance adjuster license</p></li></ul><p></p><p><i>
Lowe&rsquo;s is an equal opportunity employer and administers all personnel practices without regard to race, color, religious creed, sex, gender, age, ancestry, national origin, mental or physical disability or medical condition, sexual orientation, gender identity or expression, marital status, military or veteran status, genetic information, or any other category protected under federal, state, or local law.</i></p>
Pay Range: $61,600.00 - $102,900.00 annually Starting rate of pay may vary based on factors including, but not limited to, position offered, location, education, training, and/or experience. For information regarding our benefit programs and eligibility, please visit https://talent.lowes.com/us/en/benefits.</div>

Senior Claims Examiner

Impact Workforce Solutions

<div>Risk Management Coordinator / Workers Compensation Coordinator<br>
Griffin, GA<br>
<br>
<b>Job Overview:</b><br>
As the <b>Workers' Compensation Claims Specialist</b>, you are responsible for the day-to-day management of workers' compensation claims. In this role, you will coordinate injury reporting, communicate with internal and external partners, and ensure claims are handled accurately, timely, and in compliance with applicable requirements. You will also support Associates throughout the claims process and help facilitate safe and timely return-to-work plans.<br>
<br>
<b>Responsibilities:</b><ul><li>
As the Workers' Compensation Specialist, you are responsible for the day-to-day management of workers' compensation claims.</li><li>
In this role, you will coordinate injury reporting, communicate with internal and external partners, and ensure claims are handled accurately, timely, and in compliance with applicable requirements</li><li>
You will also support Associates throughout the claims process and help facilitate safe and timely return-to-work plans</li><li>
Manage workers' compensation claims from initial injury report through resolution with support from your direct report</li><li>
Process first reports of injury by coordinating with Associates, management, and medical providers</li><li>
Communicate regularly with third-party administrators, medical providers, attorneys, case managers, and internal teams to coordinate care and resolve claim issues</li><li>
Determine claim eligibility by reviewing information, investigations, or available footage when needed</li><li>
Calculate weekly wage replacement benefits and prepare wage statements for injured Associates</li><li>
Maintain accurate and organized claims documentation, including scanning and archiving records</li></ul><b>
Qualifications:</b><ul><li>
1-3 years of experience in environmental safety and health or a related field.</li><li>
Bachelor&rsquo;s degree in Occupational Safety and Health, Risk Management, or a related field preferred, or equivalent experience.</li><li>
Basic knowledge of Workers Compensation, OSHA regulations, and claims handling best practices.</li><li>
Self-motivated and resourceful, capable of working independently in a fast-paced environment.</li><li>
Strong communication skills to effectively present risk mitigation strategies.</li><li>
Proficiency in MS Office suite, including Word, Excel, PowerPoint, and Outlook.</li><li>
Ability to analyze trends and propose solutions.</li><li>
Willingness to travel overnight as necessary to client sites.</li><li>
Certification in First Aid/CPR is a plus.</li></ul><b>
Company Overview:</b><br>
No matter what stage of your career, Impact Workforce Solutions can help you achieve your goals and realize your full potential. At IWS, teamwork is critical to our success, and we place a tremendous value on how we work together in our immediate teams, between our business units, and across our entire company. By delivering customized, strategic human capital solutions to our clients across a multitude of industries, we are recognized as the leader in the industry. With more than 2 decades in the industry, our commitment to improving the quality of life for people shows a genuine passion and caring spirit that helps not only our clients, but also our work-family to be successful.<br>
<br>
To be successful in this role, you will possess exceptional customer service skills, be analytical and detail oriented, have strong organizational skills, and be able to work in a team environment. The ideal candidate will have excellent written and oral communication skills and be able to communicate effectively at all levels.<br>
In return, we offer a competitive salary (up to mid-sixties annual base salary), a full suite of employer sponsored benefits to include health insurance, dental, vision, life, disability, 401k retirement plan and many additional perks, a professional learning environment, paid time off, paid holidays, a fun and professional team environment, and exciting career &amp; growth opportunities.<p><i>
Thank you for your interest in Impact Workforce Solutions, we are proud to be an Equal Employment Opportunity Employer and participate in the E-Verify eligibility confirmation program.</i></p><p>
</p><p>LhXsqQ0Fpg</p></div>

Workers Compensation Claims Specialist

CCMSI

<div>Overview:
<div><b>
Position Title:</b> Workers' Compensation Claim Consultant (MA, CT, RI)<br>
<b>Location:</b> Reading, MA (hybrid preferreed, remote considered)<br>
<b>Schedule:</b> 8:00 am-4:00 pm ET<br>
<b>Salary Range:</b> $75,000-$85,000</div><p></p><h3 class="jobSectionHeader"><b>
Build Your Career With Purpose at CCMSI</b></h3><div>
At CCMSI, we partner with global clients to solve their most complex risk management challenges, delivering measurable results through advanced technology, collaborative problem-solving, and an unwavering commitment to their success.</div><div></div><div><br>
We don&rsquo;t just process claims&mdash;we support people. As the largest privately owned Third Party Administrator (TPA), CCMSI delivers customized claim solutions that help our clients protect their employees, assets, and reputations. We are a certified Great Place to Work&reg;, and our employee-owners are empowered to grow, collaborate, and make meaningful contributions every day.</div><h3 class="jobSectionHeader"><b>
Job Summary</b></h3><div></div><div><br>
We are seeking an experienced and highly skilled <b>Workers&rsquo; Compensation Claim Consultant</b> to manage a complex portfolio of claims with confidence, empathy, and sound professional judgment. With 5+ years of hands‑on claims experience, you will lead thorough investigations, guide claim strategy, and ensure fair, timely resolutions. This role also offers a strong development pathway for advancement into more senior claim positions. As a Claim Consultant, you will play a key role in delivering exceptional service to CCMSI clients and upholding our high standards of quality and responsiveness.</div><div>
</div><div><div><i>
This is a full life‑cycle WC adjuster position within a TPA environment, and only candidates with proven Workers&rsquo; Compensation claims experience will be considered.</i></div></div><br>
<div></div>
Responsibilities:
<div>
When we hire Workers&rsquo; Compensation Adjusters at CCMSI, we look for detail‑driven problem‑solvers who balance empathy with sound judgment, navigate complex regulations with confidence, and deliver fair, timely outcomes that support injured workers and strengthen client trust.</div><ul><li>
Investigate, evaluate and adjust claims in accordance with established claim handling standards and laws.</li><li>
Establish reserves and/or provide reserve recommendations within established reserve authority levels.</li><li>
Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated claims. Negotiate any disputed bills or invoices for resolution.</li><li>
Authorize and make payments of claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority.</li><li>
Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate.</li><li>
Assist in the selection, referral and supervision of designated claim files sent to outside vendors. (i.e. legal, surveillance, case management, etc.)</li><li>
Assess and monitor subrogation claims for resolution.</li><li>
Review and maintain personal diary on claim system.</li><li>
Client satisfaction.</li><li>
Prepare reports detailing claim status, payments and reserves, as requested.</li><li>
Compute disability rates in accordance with state laws.</li><li>
Effective and timely coordination of communication with clients, claimants and appropriate parties throughout the claim adjustment process.</li><li>
Prepare newsletter articles, as requested.</li><li>
Provide notices of qualifying claims to excess/reinsurance carriers.</li><li>
Handle more complex and involved claims than lower level claim positions with minimum supervision.</li><li>
Conduct claim reviews and/or training sessions for designated clients, as requested.</li><li>
Attend and participate at hearings, mediations, and informal legal conferences, as appropriate.</li><li>
Compliance with Corporate Claim Handling Standards and special client handling instructions as established.</li></ul><br>
<div></div>
Qualifications:<div></div><div><h2 class="jobSectionHeader"><b><br>
Required Qualifications</b></h2><ul><li><b>
Five or more years of Workers&rsquo; Compensation claims experience.</b></li><li>
Proficiency with Microsoft Office products, including Word, Excel, and Outlook.</li><li>
Adjuster&rsquo;s license may be required based on jurisdiction.</li><li><b>
Experience handling CT and RI workers' compensation claims required.</b></li></ul><h2 class="jobSectionHeader"><b>
Preferred Qualifications</b></h2><ul><li>
Bachelor&rsquo;s degree is preferred but not required.</li><li><b>
Bilingual (Spanish) proficiency</b> &mdash; highly valued for communicating with claimants, employers, or vendors, but not required.</li></ul><div><b>
Why You&rsquo;ll Love Working Here</b></div><div></div><ul><li><b><br>
4 weeks </b><b><i>(Paid time off that accrues throughout the year in accordance with company policy)</i></b><b> + 10 paid holidays in your first year</b></li><li><b>
Comprehensive benefits</b>: Medical, Dental, Vision, Life, and Disability Insurance</li><li><b>
Retirement plans</b>: 401(k) and Employee Stock Ownership Plan (ESOP)</li><li><b>
Career growth</b>: Internal training and advancement opportunities</li><li><b>
Culture</b>: A supportive, team-based work environment</li></ul><div></div><div><b><br>
How We Measure Success</b></div><div></div><div><br>
 At CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by:
</div><ul><li><b>Quality claim handling</b> &ndash; thorough investigations, strong documentation, well-supported decisions</li><li><b>
Compliance &amp; audit performance</b> &ndash; adherence to jurisdictional and client standards</li><li><b>
Timeliness &amp; accuracy</b> &ndash; purposeful file movement and dependable execution</li><li><b>
Client partnership</b> &ndash; proactive communication and strong follow-through</li><li><b>
Professional judgment</b> &ndash; owning outcomes and solving problems with integrity</li><li><b>
Cultural alignment</b> &ndash; believing every claim represents a real person and acting accordingly</li></ul><div><b><i>
This is where we shine, and we hire adjusters who want to shine with us.</i></b></div><div></div><div><b><i><br>
Compensation &amp; Compliance</i></b></div><div><i>
The posted salary reflects CCMSI&rsquo;s good-faith estimate in accordance with applicable pay transparency laws. </i><i>Actual compensation will be based on qualifications, experience, geographic location, and internal equity. This role may also qualify for bonuses or additional forms of pay.</i></div><div></div><div><i><br>
CCMSI offers comprehensive benefits including medical, dental, vision, life, and disability insurance. Paid time off accrues throughout the year in accordance with company policy, with paid holidays and eligibility for retirement programs in accordance with plan documents.</i></div><div></div><div><b><i><br>
Visa Sponsorship:</i></b><i> CCMSI does not provide visa sponsorship for this position.</i><br>
<b><i>ADA Accommodations:</i></b><i> CCMSI is committed to providing reasonable accommodations throughout the application and hiring process.</i><br>
<b><i>Equal Opportunity Employer:</i></b><i> CCMSI complies with all applicable employment laws, including pay transparency and fair chance hiring regulations.</i></div><div></div><div><i><br>
Background checks, if required for the role, are conducted only after a conditional offer and in accordance with applicable fair chance hiring laws.</i></div><div></div><div><b><br>
Our Core Values</b></div><div></div><div><br>
At CCMSI, we believe in doing what&rsquo;s right&mdash;for our clients, our coworkers, and ourselves. We look for team members who:</div><div></div><ul><li><b><br>
Lead with transparency </b>We build trust by being open and listening intently in every interaction.
</li><li><b>Perform with integrity </b>We choose the right path, even when it is hard.
</li><li><b>Chase excellence </b>We set the bar high and measure our success. What gets measured gets done.
</li><li><b>Own the outcome </b>Every employee is an owner, treating every claim, every decision, and every result as our own.
</li><li><b>Win together </b>Our greatest victories come when our clients succeed.</li></ul><p></p><div><b><br>
We don&rsquo;t just work together&mdash;we grow together. If that sounds like your kind of workplace, we&rsquo;d love to meet you.</b></div><div></div><div><br>
#CCMSICareers #EmployeeOwned #GreatPlaceToWorkCertified #ESOP #TPA #InsuranceCareers #ClaimsCareers #IND123 #LI-Hybrid #WorkersCompensation #RhodeIsland #Connecticut #Massachusetts</div></div></div><div></div>

Workers' Compensation Claim Consultant

TEEMA Group

<div><h3 class="jobSectionHeader"><b>Role Summary</b></h3><p>
The Workers&rsquo; Compensation Claims Supervisor is a key leadership role responsible for guiding and overseeing a high-performing claims team in a fast-paced, compliance-focused environment. This position offers the opportunity to combine deep technical expertise in Texas workers&rsquo; compensation with hands-on leadership, mentorship, and client engagement. The Supervisor ensures accurate claims handling, regulatory compliance, exceptional service delivery, and continuous professional development of staff, while serving as a trusted resource for clients and internal partners.</p><p>
This is an ideal opportunity for an experienced claims leader who thrives in an in-office setting, values accountability and collaboration, and enjoys driving both operational excellence and team success.
</p><h3 class="jobSectionHeader"><b>Key Duties &amp; Responsibilities</b></h3><ul><li><p>
Supervise, mentor, and support Claims Examiners, Claims Assistants, and administrative staff</p></li><li><p>
Monitor attendance, performance, evaluations, and address disciplinary matters as needed</p></li><li><p>
Review claims activity, including initial reviews, ongoing case management, delays, and denials</p></li><li><p>
Approve reserve changes up to $250,000 and payments up to $10,000 in accordance with internal guidelines</p></li><li><p>
Conduct comprehensive file reviews to ensure compliance with Texas workers&rsquo; compensation laws, client requirements, and internal procedures</p></li><li><p>
Coordinate and lead training sessions related to regulatory updates, internal policies, and best practices</p></li><li><p>
Ensure caseloads are appropriately staffed, balanced, and managed efficiently</p></li><li><p>
Approve priority payments and sign checks as required</p></li><li><p>
Respond professionally and promptly to claimant, vendor, and client inquiries or concerns</p></li><li><p>
Monitor vendor performance and recommend or implement panel adjustments as necessary</p></li><li><p>
Ensure all client servicing instructions are consistently followed</p></li><li><p>
Provide coverage for claims examiners during absences or vacancies</p></li><li><p>
Prepare, review, and evaluate monthly client reports</p></li><li><p>
Facilitate and participate in internal and external audits</p></li><li><p>
Conduct and document educational and training sessions for internal teams and external stakeholders</p></li><li><p>
Attend client file reviews and meetings as needed</p></li><li><p>
Collaborate with leadership and sales/service teams on RFPs and client service initiatives</p></li><li><p>
Adhere to Supervisor Best Practice Guidelines</p></li><li><p>
Perform additional duties as assigned to support operational and organizational goals</p></li></ul><h3 class="jobSectionHeader"><b>
Required Qualifications</b></h3><ul><li><p>
High School Diploma or GED</p></li><li><p>
Minimum of 5 years of supervisory experience within workers&rsquo; compensation claims</p></li><li><p>
Active Texas Adjuster&rsquo;s License</p></li><li><p>
Strong working knowledge of Texas workers&rsquo; compensation statutes and regulations</p></li><li><p>
Solid understanding of medical terminology</p></li><li><p>
Proven experience supervising claims staff in a high-volume environment</p></li></ul><p></p><h3 class="jobSectionHeader"><b>
Desired Qualifications</b></h3><ul><li><p>
Bachelor&rsquo;s degree in a related field</p></li><li><p>
Experience handling Texas public entity and school district claims (highly preferred)</p></li><li><p>
Strong analytical and problem-solving capabilities</p></li><li><p>
Ability to manage diary systems, prioritize workload, and meet strict deadlines</p></li><li><p>
Excellent written and verbal communication skills</p></li><li><p>
Ability to clearly explain complex claims information to claimants, clients, and staff</p></li><li><p>
Proficiency in Microsoft Word and Excel</p></li><li><p>
Demonstrated ability to manage and mentor employees with varying experience levels</p></li><li><p>
Strong interpersonal, leadership, and coaching skills</p></li><li><p>
Ability to manage stress, multitask effectively, and maintain focus in a deadline-driven environment</p></li><li><p>
Positive, professional attitude with a strong sense of urgency and accountability</p></li></ul><h3 class="jobSectionHeader"><b>
About the Organization</b></h3><p>
This opportunity is with a well-established organization specializing in workers&rsquo; compensation and claims administration services. The organization is committed to regulatory excellence, client satisfaction, and fostering a collaborative, professional work environment that supports growth, leadership development, and long-term career success.
</p><h3 class="jobSectionHeader"><b>Location &amp; Work Type</b></h3><ul><li><p><b>
Location:</b> Irving, Texas</p></li><li><p><b>
Work Type:</b> On-site, in-office role</p></li></ul>
#Workwolf</div>

Workers’ Compensation Claims Supervisor

<div><p>By joining Sedgwick, you'll be part of something truly meaningful. It&rsquo;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&rsquo;s no limit to what you can achieve.
</p><p></p><p>Newsweek Recognizes Sedgwick as America&rsquo;s Greatest Workplaces National Top Companies
</p><p>Certified as a Great Place to Work&reg;
</p><p>Fortune Best Workplaces in Financial Services &amp; Insurance
</p><p></p>Workers Compensation Claims Representative | Pasadena, CA
<div><div>Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career?
</div></div><div></div><div><div><div><div><div><div><div><div><div><ul><li><p>A stable and consistent work environment in an office setting
</p></li><li><p>A training program to learn how to help employees and customers from some of the world&rsquo;s most reputable brands
</p></li><li><p>An assigned mentor and manager who will guide you on your career journey
</p></li><li><p>Career development and promotional growth opportunities through increasing responsibilities
</p></li><li><p>A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs
</p></li></ul><p></p><p><b>PRIMARY PURPOSE OF THE ROLE: </b>To process low level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements with general supervision.
</p><p></p><p><b>ARE YOU AN IDEAL CANDIDATE? </b>We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.
</p><p></p><p><b>ESSENTIAL RESPONSIBLITIES MAY INCLUDE
</b></p><ul><li><p>Processes low level workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.
</p></li><li><p>Develops and coordinates low level workers compensation claims' action plans to resolution, return-to-work efforts, and approves claim payments.
</p></li><li><p>Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract.
</p></li><li><p>Administers subrogation of claims and negotiates settlements.
</p></li><li><p>Communicates claim action with claimant and client.
</p></li><li><p>Ensures claim files are properly documented and claims coding is correct.
</p></li><li><p>May process low-level lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
</p></li><li><p>Maintains professional client relationships.
</p></li></ul><p></p><p><b>QUALIFICATIONS
</b></p><p>Education &amp; Licensing: 2 years of claims management experience or equivalent combination of education and experience required.
</p><ul><li><p>High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.
</p></li><li><p>Professional certification as applicable to line of business preferred.
</p></li></ul><p></p><p><b>TAKING CARE OF YOU
</b></p><ul><li><p>Entry-level colleagues are offered a world class training program with a comprehensive curriculum
</p></li><li><p>An assigned mentor and manager that will support and guide you on your career journey
</p></li><li><p>Career development and promotional growth opportunities
</p></li><li><p>A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more
</p></li></ul><p></p><p><i>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 $2600 - $28.00 per hour. 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.
</i></p></div></div></div></div></div></div></div></div></div><p></p><p>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&rsquo; 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.
</p><p></p><p>Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
</p><p></p><h2 class="jobSectionHeader"><b>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.</b></h2></div>

Workers Compensation Claims Representative | Pasadena, CA

<div><p>By joining Sedgwick, you'll be part of something truly meaningful. It&rsquo;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&rsquo;s no limit to what you can achieve.
</p><p></p><p>Newsweek Recognizes Sedgwick as America&rsquo;s Greatest Workplaces National Top Companies
</p><p>Certified as a Great Place to Work&reg;
</p><p>Fortune Best Workplaces in Financial Services &amp; Insurance
</p><p></p>Claims Team Lead - Workers Compensation | Brea, CA
<div><div>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&rsquo;s best brands?
</div></div><div><div><div><div><div><div><div><div><div><ul><li><p>Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.
</p></li><li><p>Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world&rsquo;s most respected organizations.
</p></li><li><p>Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
</p></li><li><p>Leverage Sedgwick&rsquo;s broad, global network of experts to both learn from and to share your insights.
</p></li><li><p>Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.
</p></li><li><p>Enjoy flexibility and autonomy in your daily work, your location, and your career path.
</p></li><li><p>Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.
</p></li></ul><p></p><p><b>ARE YOU AN IDEAL CANDIDATE? </b>We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.
</p><p></p><p><b>OFFICE LOCATIONS
</b></p><p>Brea, CA - Hybrid (3 days in office, 3 days remote)
</p><p></p><p><b>PRIMARY PURPOSE OF THE ROLE: </b>Oversees multiple teams of examiners and technical staff handling workers compensation claims for clients. 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 case.
</p><p></p><p><b>ESSENTIAL RESPONSIBLITIES MAY INCLUDE
</b></p><ul><li><p>Supervises multiple teams of examiners and technical operations colleagues, delegating duties as needed and ensuring proper licensing and documentation standards.
</p></li><li><p>Provides technical and jurisdictional guidance on claims adjudication, including quality reviews and reserve evaluations for high-cost or complex claims.
</p></li><li><p>Acts as a second-level appeal authority for client and claimant issues, implementing final decisions.
</p></li><li><p>Identifies trends, issues, and opportunities for process improvement; advises management and coordinates related projects.
</p></li><li><p>Monitors third-party and sensitive claims, including litigated and vocational rehabilitation cases.
</p></li><li><p>Maintains professional client relationships, offering recommendations and written summaries as needed.
</p></li><li><p>Ensures accurate claim coding and documentation by examiners.
</p></li></ul><p></p><p><b>QUALIFICATIONS
</b></p><p>Education &amp; Licensing: 6 years of claims experience or equivalent combination of education and experience required to include two (2) years claims supervisor experience.
</p><ul><li><p>High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.
</p></li><li><p>Professional certification as applicable to line of business preferred.
</p></li></ul><p></p><p><b>Licensing / Jurisdiction Knowledge: </b>California workers compensation claim handling experience | SIP Certified
</p><p></p><p><b>TAKING CARE OF YOU
</b></p><ul><li><p>Flexible work schedule.
</p></li><li><p>Referral incentive program.
</p></li><li><p>Career development and promotional growth opportunities.
</p></li><li><p>A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
</p></li></ul><p></p><p>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 $105,000-$115,000/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.
</p><p></p><p>#LI-GC1 #LI-Hybrid #claims #claimsteamlead
</p></div></div></div></div></div></div></div></div></div><p></p><p>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&rsquo; 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.
</p><p></p><p>Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
</p><p></p><h2 class="jobSectionHeader"><b>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.</b></h2></div>

Claims Team Lead - Workers Compensation | Brea, CA

Search 10000+ Workers' compensation claims examiner jobs near you this March. New roles added regularly across leading industries. Apply today.