Talent.com
Sedgwick
Workers Compensation - Claims Adjuster | HYBRID | Riverside, CASedgwick • Riverside, CA, United States
Workers Compensation - Claims Adjuster | HYBRID | Riverside, CA

Workers Compensation - Claims Adjuster | HYBRID | Riverside, CA

Sedgwick • Riverside, CA, United States
1 day ago
Salary
$65,000.00–$85,000.00 yearly
Job type
  • Full-time
Job description

Workers Compensation - Claims Adjuster | HYBRID | Riverside, CA

OFFICE LOCATION:

Riverside, CA (3 days In Office/2 days WFH)

PRIMARY PURPOSE: To analyze mid- and higher-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.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

  • Manages workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.
  • Develops and manages workers compensation claims' action plans to resolution, coordinates return-to-work efforts, and approves claim payments.
  • Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.
  • Manages subrogation of claims and negotiates settlements.
  • Communicates claim action with claimant and client.
  • Ensures claim files are properly documented and claims coding is correct.
  • May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
  • Maintains professional client relationships.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

  • Performs other duties as assigned.
  • Supports the organization's quality program(s).
  • Travels as required.

QUALIFICATIONS

Education & Licensing

Bachelor's degree from an accredited college or university preferred.

Experience

Three (3) years of claims management experience or equivalent combination of education and experience required.

Licensing / Jurisdiction Knowledge: California workers' compensation claims experience required | SIP Preferred

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical: Computer keyboarding, travel as required

Auditory/Visual: Hearing, vision and talking

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 $65,000 - $85,000/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.

#claimsadjuster #claims #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.

Create a job alert for this search

Workers Compensation - Claims Adjuster | HYBRID | Riverside, CA • Riverside, CA, United States

Similar jobs

Collections - Earn Up to $37/hr

TradeJobsWorkforce92518 March ARB, CA, US
$37.00 hourly
Full-time

Responsible for performing various collection duties on consumer or mortgage accounts in various stages of risk or performance to effectively reduce delinquency, losses and increase recoveries.Area... Show more

 • Promoted

Licensed Clinical Therapist I - Community Crisis Response Team*

County of San Bernardino, CASan Bernardino, CA, United States
Full-time +1

AnnuallyLocation : Throughout San Bernardino County, CAJob Type: Full-timeJob Number: 26-13131ccrt-01Department: Department of Behavioral HealthOpening Date: 02/28/2026Closing Date: ContinuousThe J... Show more

 • Promoted

URGENT HIRING - Seasonal Production Associates (2nd Shift)

Flour FusionPerris, CA, United States
Full-time

Flour Fusion LLC is hiring Seasonal Production Associates to support increased production demand and facility expansion.This role includes both packaging and material handling responsibilities.Empl... Show more

 • Promoted

$ 150 Billable Hours- WC DEFENSE SOLE PRACTIONNER NEEDS 2 REMOTE ATTYS

Match-Up Employment AgencyMenifee, CA, United States
Remote
Full-time +1

Job DescriptionJob DescriptionSMALL FIRM HAS LARGER FIRM MERGING IN TO THEM.THEY NEED 2 EXPERIENCED CA WC DEFENSE ATTORNEYS TO HANDLE THE CASELOAD.THEY USE MERUS CASE ATTORNEY MANAGEMENT PROGRAM.TH... Show more

 • Promoted

Utility Relations Specialist - 100% remote

C&L GroupPerris, CA, United States
Remote
Full-time +1

Utility Relations Specialist - 100% remote? Location :100% Remote (must work PST hours, 8 :00 AM - 5 :00 PM)? Pay Rate :$41 / hr (W2, OT eligible)? Duration :4 months contract (with potential exten... Show more

 • Promoted

Commercial Lines Underwriter - Remote - Must reside in Southern California (Preferred: Irvine, Los A

SDI StaffingMoreno Valley, CA, United States
Remote
Permanent

This is a direct hire role for an experienced underwriter who thrives in a remote work setting, and brings 7years of Commercial Lines property experience -- particularly in small to middle market r... Show more

 • Promoted

Laborer - HUD 3 Employment Opportunity

Spec Construction Co., Inc.San Bernardino, CA, United States
Full-time

Laborer HUD Section 3 Employment Opportunity Company Name:Spec Construction, Inc.Project Location:San Bernardino, CAProject Type:HUD-Funded Construction ProjectSection 3 Eligible Candidates Encoura... Show more

 • Promoted

Utility Clerk

Superior GrocersRialto, CA, United States
Full-time

Utility Clerk will be responsible for a variety of roles as assigned which include parking lot clerk, porter and Jr clerk.Perform cashier duties as needed.Focus on delivering great customer service... Show more

 • Promoted

Remote Senior Non-QM Underwriter

Paramount Residential Mortgage GroupRiverside, CA, United States
Remote
Full-time

OverviewResponsible for the prudent underwriting of Non-QM loans in accordance with company and investor guidelines.The duties for Non-QM Underwriter include but are not limited to those described ... Show more

 • Promoted

Healthcare Sales SpecialistRiverside, CA, USA

WelbeHealthRiverside, CA, United States
Full-time

WelbeHealth provides life-extending health care to our most vulnerable seniors.Our PACE model of care is unique, in that we are the health plan and the provider of primary care services that allow ... Show more

 • Promoted

Therapy & Authorization Specialist: Physical Therapy

MLee Medical EmploymentRiverside, CA, United States
Full-time

Therapy & Authorization Specialist:Physical TherapyA Rewarding Career in Riverside, California:Physical Therapy at Its BestImagine waking up each day knowing your work directly contributes to i... Show more

 • Promoted

Wealth Advisor - Arrowhead Credit Union

LPL FinancialRiverside, CA, United States
Full-time

LPL Financial collaborates with credit unions to provide a comprehensive suite of financial services tailored to their clients' needs.This exciting opportunity at Arrowhead Credit Union invites you... Show more

 • Promoted

Senior BCBA ($10,000 Bonus, Flexibility)

ABS KidsHesperia, California, United States
Full-time +1

Discover Your WOW Moment as a BCBA with ABS Kids.Ready to make a big impact with the flexibility you’ve been looking for?.Join a company founded and led by BCBAs-where your voice matters, your expe... Show more

 • Promoted

Senior Workers Compensation Claims Examiner

AcrisureMurrieta, CA, United States
Full-time

Senior Workers' Compensation Claims Examiner.Acrisure is seeking a Senior Workers' Compensation Claims Examiner to independently manage complex California workers' compensation claims from assignme... Show more

 • Promoted

Human Resources and Compensation Analyst

BournsRiverside, CA, United States
Full-time

Help us grow and evolve our global HR data collection and reporting capabilities, including the development of key workforce metrics, dashboards, and executive analytics!This position is located in... Show more

 • Promoted

Workers Compensation - Claims Adjuster | HYBRID | Riverside, CA

SedgwickRiverside, CA, United States
Full-time

Workers Compensation - Claims Adjuster | HYBRID | Riverside, CA.Riverside, CA (3 days In Office/2 days WFH).PRIMARY PURPOSE: To analyze mid- and higher-level workers compensation claims to determin... Show more

 • Promoted

(Remote) California Claims Examiner - Workers Compensation

Sedgwick Claims Management Services LtdRiverside, CA, United States
Remote
Full-time

Global Privacy PolicySedgwick's caring counts commitment is to value the right of privacy of the companies and individuals we serve.It is Sedgwick's policy to comply with all applicable privacy and... Show more

 • Promoted

Remote Life Insurance Positions

Emergent Financial GroupSan Bernardino, CA, United States
Remote
Permanent

Dynamic Life Insurance Sales OpportunityWe are a high-performing insurance team experiencing rapid expansion.Were actively seeking licensed life insurance agents to join our ranks.For those without... Show more

 • Promoted

Senior Labor and Employment Litigation Attorney (Remote + Commissions)

California United Law Group, P.C.Fontana, CA, United States
Remote
Full-time

JOB SUMMARY :Like the look of this opportunity Make sure to apply fast, as a high volume of applications is expected Scroll down to read the complete job description.We are arapidlygrowing, tech-fo... Show more

 • Promoted

Insurance Verification Specialist

Inland Eye SpecialistsMurrieta, CA, United States
Full-time

Are you a detail-oriented professional who thrives in a supportive, patient-focused environment?Inland Eye Specialist in Murrieta, CA is seeking an energetic, team-oriented Insurance Verification S... Show more