Sedgwick Logo

Sedgwick

Claims Representative - Workers Compensation | Ontario, California

Posted 23 Days Ago
Be an Early Applicant
Remote
Hiring Remotely in Ontario, ON, CAN
Senior level
Remote
Hiring Remotely in Ontario, ON, CAN
Senior level
Adjudicates complex workers compensation and liability claims by investigating exposures, managing litigation, coordinating vendors, negotiating settlements, and ensuring timely resolution. Leads team meetings, assigns follow-up actions, supports workload reviews, and assists with interviews and employee development. Requires nationwide jurisdiction knowledge, claims licensing, and supervisory capability, with responsibility for up to three direct reports.
The summary above was generated by AI

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 Representative - Workers Compensation | Ontario, California

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 Workers Compensation & supervisory 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? To analyze complex or technically difficult general liability claims to determine benefits due; to work with high exposure liability claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; to identify subrogation of claims and negotiate settlements; and to provide backup for team lead when out of the office. 

 

PRIMARY PURPOSE OF THE ROLE: 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 

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. 

Manages the litigation process; ensures timely and cost-effective claims resolution. 

Coordinates vendor referrals for additional investigation and/or litigation management. 

Leads team meetings and assigns accountability for follow-up items. 

Gathers important compliance/claims processing information to be presented at team meetings. 

Assists in interviews of adjusters, clerical staff and provides feedback to hiring manager. 

Provides limited assistance/support to team lead with monthly review of adjuster workloads; notes trends and suggests adjustments when necessary. May include up to (3) three direct reports. 

 

SUPERVISORY RESPONSIBILITIES 

Administers company personnel policies in all areas and follows company staffing standards and training recommendations. 

Interviews, hires and establishes colleague performance development plans; conducts colleague performance discussions. 

Provides support, guidance, leadership, and motivation to promote maximum performance. 

 

QUALIFICATIONS  

 

Education & Licensing: 5 years of claims management experience or equivalent combination of education and experience required. 

High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.  

Professional certification as applicable to line of business preferred. 

 

Jurisdiction Knowledge: Nationwide 

Licensing: Required 

Location: On-Site at our Ontario, CA office 

 

TAKING CARE OF YOU  

Flexible work schedule.  

Referral incentive program.  

Opportunity to work in an agile environment. 

Career development and promotional growth opportunities.  

A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one. 

 

 

WORK ENVIRONMENT REQUIREMENTS INCLUDE   
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 

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 ($26.55 - 37.18). 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. 


#claimsexaminer #claims


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.

Similar Jobs

Junior
Insurance
Processes low-level workers compensation claims, determines compensability and benefits, monitors reserves, files state documentation, coordinates return-to-work plans, approves payments, identifies subrogation opportunities, and negotiates settlements under general supervision. The role is fully on-site in Ontario, California and requires claims management experience or equivalent training.
2 Hours Ago
Easy Apply
Remote
Canada
Easy Apply
Mid level
Mid level
Cloud • Security • Software • Cybersecurity • Automation
Designs, operates, and improves production Kubernetes platforms across cloud environments. Manages ArgoCD GitOps workflows, Terraform infrastructure, CI/CD integrations, platform reliability, observability, security controls, and developer enablement. Collaborates with application teams to onboard services, create self-service tooling and documentation, respond to incidents, and improve platform availability and performance.
Top Skills: ArgocdAWSAzureBashCiliumCrossplaneDnsExternal Secrets OperatorGCPGithub ActionsGitlab CiGitopsGoGrafanaHelmIngressIstioKubernetesKyvernoLinkerdLoad BalancingLokiOpa/GatekeeperOpentelemetryPrometheusPythonSealed SecretsService MeshTektonTerraformVault
5 Hours Ago
Remote
Canada
Mid level
Mid level
Cloud • Information Technology • Productivity • Security • Software • App development • Automation
Build and operate end-to-end full-stack features for Loom billing, subscriptions, integrations, and platform migrations. Develop responsive React interfaces, scalable backend APIs and microservices, payment and identity integrations, and reliable cloud-based systems. Responsibilities include observability, monitoring, testing, code reviews, documentation, security, performance optimization, and participation in Agile ceremonies and technical design reviews.
Top Skills: AWSBitbucketCi/CdConfluenceCypressDockerGitJavaJavaScriptJestJIRAMicroservicesMochaMySQLNode.jsPostgresPythonReactRest ApisTypescript

What you need to know about the Toronto Tech Scene

Although home to some of the biggest names in tech, including Google, Microsoft and Amazon, Toronto has established itself as one of the largest startup ecosystems in the world. And with over 2,000 startups — more than 30 percent of the country's total startups — Toronto continues to attract new businesses. Be it helping entrepreneurs manage their finances, simplifying business operations by automating payroll or assisting pharmaceutical companies in launching new drugs, the city's tech scene is just getting started.

Sign up now Access later

Create Free Account

Please log in or sign up to report this job.

Create Free Account