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Claims examiner • san diego ca

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Claims Examiner - General Liability | Hawaii License Required

Claims Examiner - General Liability | Hawaii License Required

Sedgwick Claims Management Services, Inc.San Diego, CA, United States
[job_card.full_time]
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 c...[show_more][last_updated.last_updated_variable_days]
  • [promoted]
(Remote) California Claims Examiner - Workers Compensation

(Remote) California Claims Examiner - Workers Compensation

Remote StaffingSan Diego, CA, US
[filters.remote]
[job_card.full_time]
Claims Examiner - Workers Compensation.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 ...[show_more][last_updated.last_updated_variable_days]
  • [promoted]
Senior Workers' Compensation Examiner - Federal Claims

Senior Workers' Compensation Examiner - Federal Claims

AIGSan Diego, CA, US
[job_card.full_time]
Join us as a Senior Claims Adjuster to grow your experience in handling Federal Workers Compensation claims.Our Claims teams are the proven problem solvers of choice for clients, delivering consist...[show_more][last_updated.last_updated_variable_days]
  • [promoted]
Plans Examiner

Plans Examiner

Government JobsSan Diego, CA, US
[job_card.full_time]
Upcoming Scheduled Salary Increase of 3% Effective July 2026.Under the supervision of the Building Official, the Plans Examiner examines and applies building code standards when performing plan rev...[show_more][last_updated.last_updated_30]
Claims Examiner

Claims Examiner

Imagine Staffing TechnologySan Diego, CA, US
[job_card.full_time]
Workers Compensation Claims Examiner (1360552).Mary Kraft is seeking an experienced Workers Compensation Claims Examiner to analyze complex or technically difficult workers' compensation claims...[show_more][last_updated.last_updated_30]
Senior Claims Examiner - Remote or Hybrid

Senior Claims Examiner - Remote or Hybrid

ATHENS ADMINISTRATORSSan Diego, CA
[filters.remote]
[job_card.full_time]
Workers’ Compensation California.Next step in progression could include Lead Senior Claims Examiner or Claims Supervisor. Explore the Athens Administrators difference : We have been dynamic, innovati...[show_more][last_updated.last_updated_variable_days]
Claims Examiner - General Liability | Hawaii License Required

Claims Examiner - General Liability | Hawaii License Required

SedgwickSan Diego, CA
[job_card.full_time]
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 c...[show_more][last_updated.last_updated_30]
  • [promoted]
Market Conduct Examiner

Market Conduct Examiner

RSMSan Diego, CA, US
[job_card.full_time]
We are the leading provider of professional services to the middle market globally, our purpose is to instill confidence in a world of change, empowering our clients and people to realize their ful...[show_more][last_updated.last_updated_30]
Mobile Examiner

Mobile Examiner

APPS Paramedical ServicesSan Diego, California, United States
[job_card.part_time]
[filters_job_card.quick_apply]
We are a local branch of a national healthcare company that seeks a California Licensed Phlebotomist (CPT) or LVN w / Blood withdrawal certification for a Mobile Medical Examiner position.We are the...[show_more][last_updated.last_updated_30]
  • [promoted]
Claims Investigator

Claims Investigator

Command InvestigationsSan Diego, CA, US
[job_card.full_time] +1
Seeking experienced investigator with multi-lines investigations to include AOE / COE, General Liability, and Auto, with Homeowners highly desired. SIU experience is also highly desired, but not requi...[show_more][last_updated.last_updated_30]
  • [promoted]
  • [new]
Mobile Phlebotomy / Paramedical Examiner

Mobile Phlebotomy / Paramedical Examiner

ExamOneSan Diego, CA, United States
[job_card.part_time]
As a Mobile Collector, you would be a part-time, on-call, and at-will employee.On-Call and At-Will equal Flexibility! You will choose the days and hours you wish to work and the areas you wish to w...[show_more][last_updated.last_updated_variable_hours]
Claims Examiner - Workers Compensation

Claims Examiner - Workers Compensation

Apidel TechnologiesSan Diego, CA, US
[job_card.full_time]
Remote in CA however, if candidate is near San Diego or Roseville office, client would like to have a hybrid role but not a deal breaker. Min 3 years of experience with CA claims mandatory.CA SIP pr...[show_more][last_updated.last_updated_30]
Senior Claims Examiner

Senior Claims Examiner

BerkleyMurray Canyon Road, CA, San Diego
[job_card.full_time]
Preferred Employers Insurance, A Berkley Company.The company serves three major Product / Client Segments : Small Business, Mid-Larger Businesses and Group Association Members (Programs).The company’s...[show_more][last_updated.last_updated_30]
Senior Claims Examiner - San Diego, CA (92101)

Senior Claims Examiner - San Diego, CA (92101)

WR BerkleySan Diego, California
[job_card.full_time]
Company Details Preferred Employers Insurance, A Berkley Company specializes in providing workers' compensation insurance to California business owners.The company serv...[show_more][last_updated.last_updated_30]
Commercial Auto Claims Adjuster / Examiner - REMOTE

Commercial Auto Claims Adjuster / Examiner - REMOTE

Work At Home Vintage ExpertsSan Diego, CA, US
[filters.remote]
[job_card.full_time] +2
[filters_job_card.quick_apply]
Put your Insurance Experience to work – FROM HOME!.Our unique platform provides you with.WHAT YOU’LL LOVE ABOUT WAHVE.We created a welcoming place to work with friendly and professional...[show_more][last_updated.last_updated_variable_days]
  • [promoted]
Senior Claims Examiner

Senior Claims Examiner

W.R. BerkleySan Diego, CA, US
[job_card.full_time]
Senior Workers' Compensation Examiner.The Senior Workers' Compensation Examiner is responsible for the analysis and management of complex workers' compensation claims. This position will review, inv...[show_more][last_updated.last_updated_30]
  • [promoted]
Claims Examiner I

Claims Examiner I

Astiva Health, IncSan Diego, CA, US
[job_card.full_time]
Orange, CA is a premier healthcare provider specializing in Medicare and HMO services.With a focus on delivering comprehensive care tailored to the needs of our diverse community, we prioritize acc...[show_more][last_updated.last_updated_variable_days]
  • [promoted]
(Remote) California Claims Examiner - Workers Compensation

(Remote) California Claims Examiner - Workers Compensation

San Diego StaffingSan Diego, CA, US
[filters.remote]
[job_card.full_time]
Claims Examiner - Workers Compensation.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 ...[show_more][last_updated.last_updated_variable_days]
Mobile Medical Examiner

Mobile Medical Examiner

Talon & Family IncSan Diego, CA, US
[job_card.full_time]
We are a local branch of a national healthcare company that seeks a California Licensed Phlebotomist or LVN w / Blood withdrawal certification for a Mobile Medical Examiner position.We are the large...[show_more][last_updated.last_updated_30]
Claims Examiner - General Liability | Hawaii License Required

Claims Examiner - General Liability | Hawaii License Required

Sedgwick Claims Management Services, Inc.San Diego, CA, United States
[job_card.variable_days_ago]
[job_preview.job_type]
  • [job_card.full_time]
[job_card.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

Claims Examiner - General Liability | Hawaii License Required

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

Hybrid 2 Days In-Office

PRIMARY PURPOSE : To analyze complex or technically difficult general liability 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 general liability 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.
  • Assesses liability and resolves claims within evaluation.
  • 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.

    Skills & Knowledge

  • 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
  • Analytical and interpretive skills
  • Strong organizational skills
  • Good interpersonal skills
  • Excellent negotiation skills
  • Ability to work in a team environment
  • Ability to meet or exceed Service Expectations
  • 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 #Hybrid #LI-HYBRID

    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.