workers' compensation claims supervisor

TEEMA Group

<div><h3 class="jobSectionHeader">Role Summary</h3>
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.
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.
<h3 class="jobSectionHeader">Key Duties &amp; Responsibilities</h3><ul><li>
Supervise, mentor, and support Claims Examiners, Claims Assistants, and administrative staff</li><li>
Monitor attendance, performance, evaluations, and address disciplinary matters as needed</li><li>
Review claims activity, including initial reviews, ongoing case management, delays, and denials</li><li>
Approve reserve changes up to $250,000 and payments up to $10,000 in accordance with internal guidelines</li><li>
Conduct comprehensive file reviews to ensure compliance with Texas workers&rsquo; compensation laws, client requirements, and internal procedures</li><li>
Coordinate and lead training sessions related to regulatory updates, internal policies, and best practices</li><li>
Ensure caseloads are appropriately staffed, balanced, and managed efficiently</li><li>
Approve priority payments and sign checks as required</li><li>
Respond professionally and promptly to claimant, vendor, and client inquiries or concerns</li><li>
Monitor vendor performance and recommend or implement panel adjustments as necessary</li><li>
Ensure all client servicing instructions are consistently followed</li><li>
Provide coverage for claims examiners during absences or vacancies</li><li>
Prepare, review, and evaluate monthly client reports</li><li>
Facilitate and participate in internal and external audits</li><li>
Conduct and document educational and training sessions for internal teams and external stakeholders</li><li>
Attend client file reviews and meetings as needed</li><li>
Collaborate with leadership and sales/service teams on RFPs and client service initiatives</li><li>
Adhere to Supervisor Best Practice Guidelines</li><li>
Perform additional duties as assigned to support operational and organizational goals</li></ul><h3 class="jobSectionHeader">
Required Qualifications</h3><ul><li>
High School Diploma or GED</li><li>
Minimum of 5 years of supervisory experience within workers&rsquo; compensation claims</li><li>
Active Texas Adjuster&rsquo;s License</li><li>
Strong working knowledge of Texas workers&rsquo; compensation statutes and regulations</li><li>
Solid understanding of medical terminology</li><li>
Proven experience supervising claims staff in a high-volume environment</li></ul><h3 class="jobSectionHeader">
Desired Qualifications</h3><ul><li>
Bachelor&rsquo;s degree in a related field</li><li>
Experience handling Texas public entity and school district claims (highly preferred)</li><li>
Strong analytical and problem-solving capabilities</li><li>
Ability to manage diary systems, prioritize workload, and meet strict deadlines</li><li>
Excellent written and verbal communication skills</li><li>
Ability to clearly explain complex claims information to claimants, clients, and staff</li><li>
Proficiency in Microsoft Word and Excel</li><li>
Demonstrated ability to manage and mentor employees with varying experience levels</li><li>
Strong interpersonal, leadership, and coaching skills</li><li>
Ability to manage stress, multitask effectively, and maintain focus in a deadline-driven environment</li><li>
Positive, professional attitude with a strong sense of urgency and accountability</li></ul><h3 class="jobSectionHeader">
About the Organization</h3>
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.
<h3 class="jobSectionHeader">Location &amp; Work Type</h3><ul><li>
Location: Irving, Texas</li><li>
Work Type: On-site, in-office role</li></ul>
#Workwolf</div>

Workers’ Compensation Claims Supervisor

CCMSI

Overview: Position Title: Workers' Compensation Claim Supervisor, Technical-Dedicated Client Program-(NC focus, some SC, VA, GA) Location: Maitland, FL Schedule: 8:00 am-4:30 pm ET Salary Range: $70,000-$100,000 Build Your Career With Purpose at CCMSI 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. 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. The Workers&rsquo; Compensation Claim Supervisor, Technical position is responsible for the supervision and oversight, investigation, adjustment, supervision of assigned workers&rsquo; compensation claims. This position may be used as an advanced training position for consideration for promotion to a management position. Accountable for the quality of workers&rsquo; compensation claim services as perceived by CCMSI clients and within our Corporate Claim Standards. Responsibilities: Review, assign and provide supervision of all workers&rsquo; compensation claim activity for designated claims to ensure compliance with Corporate Claim Standards, client specific handling instructions and in accordance with applicable laws and State licensure requirements. Investigate, evaluate and adjust assigned workers&rsquo; compensation claims in accordance with established claim management standards and laws. Reserve establishment and/or oversight of reserves for designated claims within established reserve authority levels. Responsible for providing litigation management oversight, direction and analysis including: attorney identification and selection criteria, litigation planning and budgeting, status reporting, strategic resolution facilitation and overall direction of litigated claim files. Provide oversight of medical and miscellaneous invoices to determine if reasonable and related to the designated claim. Negotiate any disputed bills or invoices for resolution. Authorize and make payments of workers&rsquo; compensation claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority. Direct handling of designated complex claims. Supervision of all claim activity for specified accounts. Compliance with Corporate Claim Handling Standards and special client handling instructions as established. Act as a Workers&rsquo; Compensation subject matter expert to highly involved dedicated client group. Attend meetings and provide guidance and feedback on the Workers&rsquo; Compensation process. Extremely high degree of customer service and consultative nature is required. Qualifications: Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Excellent oral and written communication skills. Initiative to set and achieve performance goals. Good analytic and negotiation skills. Ability to cope with job pressures in a constantly changing environment. Knowledge of all lower-level claim position responsibilities. Must be detail oriented and a self-starter with strong organizational abilities. Ability to coordinate and prioritize required. Flexibility, accuracy, initiative and the ability to work with minimum supervision. Discretion and confidentiality required. Reliable, predictable attendance within client service hours for the performance of this position. Responsive to internal and external client needs. Ability to clearly communicate verbally and/or in writing both internally and externally. Education and/or Experience Seven (7) years of claim experience is required. Bachelor&rsquo;s Degree is preferred. NC focus, some SC, VA, GA, and ability to learn other jurisdictions. Nice to Have: Bilingual (Spanish) proficiency &mdash; highly valued for communicating with claimants, employers, or vendors, but not required. Computer Skills Proficient with Microsoft Office programs. Certificates, Licenses, Registrations Adjuster&rsquo;s license may be required based upon jurisdiction. AIC preferred. Why You&rsquo;ll Love Working Here 4 weeks (Paid time off that accrues throughout the year in accordance with company policy) + 10 paid holidays in your first year Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP) Career growth: Internal training and advancement opportunities Culture: A supportive, team-based work environment How We Measure Success At CCMSI, great adjusters stand out through ownership, accuracy, and impact. We measure success by: Quality claim handling &ndash; thorough investigations, strong documentation, well-supported decisions Compliance &amp; audit performance &ndash; adherence to jurisdictional and client standards Timeliness &amp; accuracy &ndash; purposeful file movement and dependable execution Client partnership &ndash; proactive communication and strong follow-through Professional judgment &ndash; owning outcomes and solving problems with integrity Cultural alignment &ndash; believing every claim represents a real person and acting accordingly This is where we shine, and we hire adjusters who want to shine with us. Compensation &amp; Compliance The posted salary reflects CCMSI&rsquo;s good-faith estimate in accordance with applicable pay transparency laws. 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. 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. CCMSI posts internal career opportunities in compliance with applicable state and local promotion transparency laws. Visa Sponsorship: CCMSI does not provide visa sponsorship for this position. ADA Accommodations: CCMSI is committed to providing reasonable accommodations throughout the application and hiring process. Equal Opportunity Employer: CCMSI complies with all applicable employment laws, including pay transparency and fair chance hiring regulations. Background checks, if required for the role, are conducted only after a conditional offer and in accordance with applicable fair chance hiring laws. Our Core Values At CCMSI, we believe in doing what&rsquo;s right&mdash;for our clients, our coworkers, and ourselves. We look for team members who: Lead with transparency We build trust by being open and listening intently in every interaction. Perform with integrity We choose the right path, even when it is hard. Chase excellence We set the bar high and measure our success. What gets measured gets done. Own the outcome Every employee is an owner, treating every claim, every decision, and every result as our own. Win together Our greatest victories come when our clients succeed. 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. #EmployeeOwned #GreatPlaceToWorkCertified #CCMSICareers #CCMSICareers #ESOP #MaitlandFL #WorkComp #Supervisor #IND123 #LI-Hybrid

Workers' Compensation Claim Supervisor Technical

Cala Sourcing Solutions LLC

<div><h2 class="jobSectionHeader">Workers&rsquo; Compensation Claims Adjuster (Level II or III) &ndash; Hawaii</h2>
Location: Kapolei, HI (Hybrid for local candidates | Remote for candidates outside the island but must be in Hawaii)<h3 class="jobSectionHeader">
Position Summary</h3>
A leading Third Party Administrator is seeking an experienced Workers&rsquo; Compensation Claims Adjuster to manage a diverse caseload of Hawaii workers&rsquo; compensation claims. Reporting to Claims Leadership, this role is responsible for end-to-end claim ownership&mdash;from intake and investigation through resolution&mdash;while operating within established authority levels and client guidelines.
This position involves regular collaboration with injured workers, employers, medical providers, attorneys, vendors, and internal partners. Claim complexity, litigation exposure, settlement authority, and leadership expectations will align with the Adjuster&rsquo;s level (Examiner II or Examiner III).<h3 class="jobSectionHeader">
Core Responsibilities (Examiner II &amp; III)</h3><ul><li>
Oversee a full inventory of workers&rsquo; compensation claims, including medical-only, indemnity, future medical, and litigated files</li><li>
Conduct prompt and comprehensive claim investigations; document findings thoroughly and accurately</li><li>
Evaluate compensability and administer benefits in compliance with Hawaii statutes and applicable claim-handling instructions</li><li>
Coordinate medical care, authorize treatment, and manage medical billing activity</li><li>
Serve as the primary point of contact for claimants, employers, providers, vendors, and clients</li><li>
Establish, review, and adjust claim reserves in accordance with company and client standards</li><li>
Maintain detailed claim notes, action plans, and diary entries reflecting claim strategy and progress</li><li>
Negotiate, resolve, and close claims within assigned settlement authority</li><li>
Perform regular file reviews and respond to client inquiries in a timely manner</li><li>
Identify emerging trends, risk indicators, and safety concerns; communicate insights proactively</li><li>
Utilize claims systems and internal technology to manage workload efficiently</li><li>
Comply with all internal policies, procedures, and best practices</li><li>
Complete additional duties as assigned</li></ul><h3 class="jobSectionHeader">
Advanced / Senior-Level Responsibilities (Primarily Examiner III)</h3><ul><li>
Independently manage highly complex, catastrophic, and litigated workers&rsquo; compensation claims</li><li>
Retain and collaborate with defense counsel; actively participate in hearings, mediations, and settlement negotiations</li><li>
Evaluate and pursue:<ul><li>
Subrogation opportunities</li><li>
Apportionment considerations</li><li>
Excess coverage reporting and reimbursement</li></ul></li><li>
Support regulatory compliance through audit preparation and state-required reporting</li><li>
Develop proactive claim strategies focused on timely, cost-effective resolution</li><li>
Participate in client file reviews and meetings as requested</li><li>
Provide mentoring and technical support to junior Claims Examiners</li><li>
Handle multi-jurisdictional claims when assigned</li></ul><h3 class="jobSectionHeader">
Qualifications</h3><h4 class="jobSectionHeader">
Education &amp; Experience</h4>
Claims Examiner II<ul><li>
Bachelor&rsquo;s degree in a related discipline preferred</li><li>
3+ years of workers&rsquo; compensation claims experience, or an equivalent combination of education and experience</li></ul>
Claims Examiner III<ul><li>
5+ years of progressive workers&rsquo; compensation claims experience</li><li>
Proven experience managing complex and litigated indemnity claims</li></ul><h3 class="jobSectionHeader">
Knowledge, Skills &amp; Abilities</h3><ul><li>
Strong working knowledge of workers&rsquo; compensation laws, regulations, and medical terminology</li><li>
Ability to independently assess risk, analyze complex issues, and manage claims strategically</li><li>
Clear, professional written and verbal communication skills</li><li>
Strong organizational, analytical, and time-management capabilities</li><li>
Ability to communicate effectively with diverse stakeholders at all organizational levels</li><li>
Proficiency with Microsoft Word and Excel preferred</li></ul><h3 class="jobSectionHeader">
Licensure</h3><ul><li>
Active Hawaii Workers&rsquo; Compensation Adjuster License required</li></ul>
#Workwolf</div>

Claims Supervisor - Workers Compensation

Gallagher

<div>Introduction 
<div>
At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it&rsquo;s our purpose. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people&rsquo;s lives. It takes empathy, precision, and a strong sense of partnership&mdash;and that&rsquo;s exactly what you&rsquo;ll find here. We&rsquo;re a team of fast-paced fixers, empathetic experts, and outcomes drivers &mdash; people who care deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving processes, you&rsquo;ll play a vital role in helping businesses and individuals move forward with confidence. Here, you&rsquo;ll be supported by a culture that values teamwork, encourages curiosity, and celebrates the impact of your work. Because when you&rsquo;re here, you&rsquo;re part of something bigger. You&rsquo;re part of a team that shows up, stands together, and leads with purpose.
</div> 
Overview 
<ul><li>
Jurisdictions: California</li><li>
Licenses: An active CA Designation is required (up to date on CE hours). SIP optional.</li><li>
Location: This role is eligible for fully remote work.</li></ul>
 
How you'll make an impact 
<ul><li>
Apply claims management experience to execute decision-making to analyze claims exposure, plan the proper course of action, and appropriately resolve claims.</li><li>
Interact extensively with various parties involved in the claim process to ensure effective communication and resolution.</li><li>
Provide exceptional customer service to our claimants on behalf of our clients exhibiting empathy through each step of the claims process.</li><li>
Handle claims consistent with clients' and corporate policies, procedures, and standard methodologies in accordance with statutory, regulatory, and ethics requirements.</li><li>
Document and communicate claim activity timely and efficiently, supporting the outcome of the claim file.</li></ul>
 
About You<ul><li> 
Claims Background: Minimum of 3-5 years of hands on workers compensation adjusting experience including handling a lost time/indemnity desk plus litigation.</li><li>Jurisdictional Experience: California Workers Compensation</li><li>Active Adjusters' licenses: CA Designation required. SIP optional.</li></ul><div></div><div> 
As a key member of our experienced Claims Adjuster team, you will:</div><div></div><ul><li> 
Investigate, evaluate, and resolve complex workers compensation claims applying your analytical skills to make informed decisions and bring claims to resolution.</li><li>Work in partnership with our clients to deliver innovative solutions and enhance the claims management process</li><li>Think critically, solve problems, plan, and prioritize tasks to optimally serve clients and claimants</li></ul><div></div><div> 
REQUIRED QUALIFICATIONS:</div><ul><li>High School Diploma.</li><li>Minimum of 5 years related claims experience.</li><li>Appropriately licensed and/or certified in all states in which claims are being handled.</li><li>Knowledge of accepted industry standards and practices.</li><li>Computer experience with related claims and business software.</li></ul><div></div><div> 
DESIRED:</div><ul><li>Bachelor's Degree</li></ul><div></div><div> 
#LI-HS1</div><div>
#LI-Remote</div> 
 
Compensation and benefits 
We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits.
Below are the minimum core benefits you&rsquo;ll get, depending on your job level these benefits may improve:
<ul><li>Medical/dental/vision plans, which start from day one!</li><li>
Life and accident insurance</li><li>
401(K) and Roth options</li><li>
Tax-advantaged accounts (HSA, FSA)</li><li>
Educational expense reimbursement</li><li>
Paid parental leave</li></ul><div>
Other benefits include:</div><ul><li>
Digital mental health services (Talkspace)</li><li>
Flexible work hours (availability varies by office and job function)</li><li>
Training programs</li><li>
Gallagher Thrive program &ndash; elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing</li><li>
Charitable matching gift program</li><li>
And more...</li></ul><div>
**The benefits summary above applies to fulltime positions. If you are not applying for a fulltime position, details about benefits will be provided during the selection process.</div><div></div><div> 
We value inclusion and diversity</div>
Click Here to review our U.S. Eligibility Requirements
Inclusion and diversity (I&amp;D) is a core part of our business, and it&rsquo;s embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work.
Gallagher embraces our employees&rsquo; diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest.
Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on race, color, religion, creed, gender (including pregnancy status), sexual orientation, gender identity (which includes transgender and other gender non-conforming individuals), gender expression, hair expression, marital status, parental status, age, national origin, ancestry, disability, medical condition, genetic information, veteran or military status, citizenship status, or any other characteristic protected (herein referred to as &ldquo;protected characteristics&rdquo;) by applicable federal, state, or local laws.
Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified person with a disability, unless the accommodation would impose an undue hardship on the operation of our business.</div>

Senior Workers Compensation Claims Adjuster - California

Sedgwick

<div>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.
Newsweek Recognizes Sedgwick as America&rsquo;s Greatest Workplaces National Top Companies
Certified as a Great Place to Work&reg;
Fortune Best Workplaces in Financial Services &amp; Insurance
Workers Compensation Claims Team Lead | 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&rsquo;s best brands?
<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>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 (3 days in office, 2 days remote)
PRIMARY PURPOSE OF THE ROLE: 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.
ESSENTIAL RESPONSIBLITIES MAY INCLUDE
<ul><li>Supervises multiple teams of examiners and technical operations colleagues, delegating duties as needed and ensuring proper licensing and documentation standards.
</li><li>Provides technical and jurisdictional guidance on claims adjudication, including quality reviews and reserve evaluations for high-cost or complex claims.
</li><li>Acts as a second-level appeal authority for client and claimant issues, implementing final decisions.
</li><li>Identifies trends, issues, and opportunities for process improvement; advises management and coordinates related projects.
</li><li>Monitors third-party and sensitive claims, including litigated and vocational rehabilitation cases.
</li><li>Maintains professional client relationships, offering recommendations and written summaries as needed.
</li><li>Ensures accurate claim coding and documentation by examiners.
</li></ul>QUALIFICATIONS
Education &amp; Licensing: 6 years of claims experience or equivalent combination of education and experience required to include two (2) years claims supervisor experience.
<ul><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>Licensing / Jurisdiction Knowledge: California workers compensation claim handling experience | SIP Certified
TAKING CARE OF YOU
<ul><li>Flexible work schedule.
</li><li>Referral incentive program.
</li><li>Career development and promotional growth opportunities.
</li><li>A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
</li></ul>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-$110,000/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.
#LI-GC1 #LI-Hybrid #claims #claimsteamlead
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.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
<h2 class="jobSectionHeader">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.</h2></div>

Workers Compensation Claims Team Lead | Roseville, CA

<div>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.
Newsweek Recognizes Sedgwick as America&rsquo;s Greatest Workplaces National Top Companies
Certified as a Great Place to Work&reg;
Fortune Best Workplaces in Financial Services &amp; Insurance
Workers Compensation Claims Representative | Ontario, CA (In-Office)
Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career?
<ul><li>A stable and consistent work environment in an office setting
</li><li>A training program to learn how to help employees and customers from some of the world&rsquo;s most reputable brands
</li><li>An assigned mentor and manager who will guide you on your career journey
</li><li>Career development and promotional growth opportunities through increasing responsibilities
</li><li>A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs
</li></ul>PRIMARY PURPOSE OF THE ROLE: 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.
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.
ESSENTIAL RESPONSIBLITIES MAY INCLUDE
<ul><li>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.
</li><li>Develops and coordinates low level workers compensation claims' action plans to resolution, return-to-work efforts, and approves claim payments.
</li><li>Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract.
</li><li>Administers subrogation of claims and negotiates settlements.
</li><li>Communicates claim action with claimant and client.
</li><li>Ensures claim files are properly documented and claims coding is correct.
</li><li>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.
</li><li>Maintains professional client relationships.
</li></ul>QUALIFICATIONS
Education &amp; Licensing: 2 years of claims management experience or equivalent combination of education and experience required.
<ul><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>TAKING CARE OF YOU
<ul><li>Entry-level colleagues are offered a world class training program with a comprehensive curriculum
</li><li>An assigned mentor and manager that will support and guide you on your career journey
</li><li>Career development and promotional growth opportunities
</li><li>A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more
</li></ul>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 $26.00 - $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.
#claims #LC-GC1
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.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
<h2 class="jobSectionHeader">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.</h2></div>

Workers Compensation Claims Representative | Ontario, CA (In-Office)

<div>Introduction 
<div>
At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it&rsquo;s our purpose. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people&rsquo;s lives. It takes empathy, precision, and a strong sense of partnership&mdash;and that&rsquo;s exactly what you&rsquo;ll find here. We&rsquo;re a team of fast-paced fixers, empathetic experts, and outcomes drivers &mdash; people who care deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving processes, you&rsquo;ll play a vital role in helping businesses and individuals move forward with confidence. Here, you&rsquo;ll be supported by a culture that values teamwork, encourages curiosity, and celebrates the impact of your work. Because when you&rsquo;re here, you&rsquo;re part of something bigger. You&rsquo;re part of a team that shows up, stands together, and leads with purpose.
</div> 
Overview<div> 
Role specifics:</div><ul><li>
Jurisdictions: NY</li><li>
Licenses: NY</li><li>
This role is eligible for fully remote work</li></ul>
 
How you'll make an impact 
<ul><li>
Apply claims management experience to execute decision-making to analyze claims exposure, plan the proper course of action, and appropriately resolve claims</li><li>
Interact extensively with various parties involved in the claim process to ensure effective communication and resolution</li><li>
Provide exceptional customer service to our claimants on behalf of our clients exhibiting empathy through each step of the claims process</li><li>
Handle claims consistent with clients' and corporate policies, procedures, and standard methodologies in accordance with statutory, regulatory, and ethics requirements</li><li>
Document and communicate claim activity timely and efficiently, supporting the outcome of the claim file</li></ul>
 
About You<div> 
Ideal candidates for this position will have:</div><ul><li>
Claims Background: workers compensation lost time/indemnity experience</li><li>
Jurisdictional Experience: NY</li><li>
Active Adjusters' licenses: NY</li></ul><div>
As a key member of our experienced Claims Adjuster team, you will:</div><ul><li>
Investigate, evaluate, and resolve complex workers compensation claims applying your analytical skills to make informed decisions and bring claims to resolution</li><li>
Work in partnership with our clients to deliver innovative solutions and enhance the claims management process</li><li>
Think critically, solve problems, plan, and prioritize tasks to optimally serve clients and claimants</li></ul><div>
Required Qualifications:</div><ul><li>
High School Diploma</li><li>
Minimum of 5 years related claims experience</li><li>
Appropriately licensed and/or certified in all states in which claims are being handled</li><li>
Knowledge of accepted industry standards and practices</li><li>
Computer experience with related claims and business software</li></ul><div>
Desired:</div><ul><li>
Bachelor's Degree</li></ul><div>
#LI-REMOTE</div><div>
#LI-KQ1</div> 
 
Compensation and benefits 
We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits.
Below are the minimum core benefits you&rsquo;ll get, depending on your job level these benefits may improve:
<ul><li>Medical/dental/vision plans, which start from day one!</li><li>
Life and accident insurance</li><li>
401(K) and Roth options</li><li>
Tax-advantaged accounts (HSA, FSA)</li><li>
Educational expense reimbursement</li><li>
Paid parental leave</li></ul><div>
Other benefits include:</div><ul><li>
Digital mental health services (Talkspace)</li><li>
Flexible work hours (availability varies by office and job function)</li><li>
Training programs</li><li>
Gallagher Thrive program &ndash; elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing</li><li>
Charitable matching gift program</li><li>
And more...</li></ul><div>
**The benefits summary above applies to fulltime positions. If you are not applying for a fulltime position, details about benefits will be provided during the selection process.</div><div></div><div> 
We value inclusion and diversity</div>
Click Here to review our U.S. Eligibility Requirements
Inclusion and diversity (I&amp;D) is a core part of our business, and it&rsquo;s embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work.
Gallagher embraces our employees&rsquo; diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest.
Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on race, color, religion, creed, gender (including pregnancy status), sexual orientation, gender identity (which includes transgender and other gender non-conforming individuals), gender expression, hair expression, marital status, parental status, age, national origin, ancestry, disability, medical condition, genetic information, veteran or military status, citizenship status, or any other characteristic protected (herein referred to as &ldquo;protected characteristics&rdquo;) by applicable federal, state, or local laws.
Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified person with a disability, unless the accommodation would impose an undue hardship on the operation of our business.</div>

Senior Workers Compensation Claims Adjuster - NY

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