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sedgwick
Workers Compensation - Claims Adjuster | HYBRID | Riverside, CA
sedgwick· Sedgwick Claims Management Services Inc.
About this role
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.
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Workers Compensation - Claims Adjuster | HYBRID | Riverside, CAOFFICE 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.
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.
Frequently Asked Questions
What is the salary for the Workers Compensation - Claims Adjuster | HYBRID | Riverside, CA role at sedgwick?
The listed salary for this Workers Compensation - Claims Adjuster | HYBRID | Riverside, CA position at sedgwick is USD 65K–85K. This is an Full time role.
Where is the Workers Compensation - Claims Adjuster | HYBRID | Riverside, CA position at sedgwick located?
This Workers Compensation - Claims Adjuster | HYBRID | Riverside, CA role at sedgwick is based in Riverside, CA. The position is listed as on-site or hybrid. Check the full job description or apply directly to confirm the work arrangement.
Is the Workers Compensation - Claims Adjuster | HYBRID | Riverside, CA role at sedgwick full-time or part-time?
This is listed as a Full time position. It is posted as a Workers Compensation - Claims Adjuster | HYBRID | Riverside, CA role in the Sedgwick Claims Management Services Inc. department at sedgwick.
Which team or department does the Workers Compensation - Claims Adjuster | HYBRID | Riverside, CA at sedgwick belong to?
This Workers Compensation - Claims Adjuster | HYBRID | Riverside, CA position is part of the Sedgwick Claims Management Services Inc. department at sedgwick. See the full job description for more information about the team structure and responsibilities.
How do I apply for the Workers Compensation - Claims Adjuster | HYBRID | Riverside, CA position at sedgwick?
Click the "Apply Now" button on this page. You will be redirected to sedgwick's official application portal hosted on workday where you can submit your application directly.
When was the Workers Compensation - Claims Adjuster | HYBRID | Riverside, CA job at sedgwick posted?
This Workers Compensation - Claims Adjuster | HYBRID | Riverside, CA position at sedgwick was posted on Aug 28, 2026. Apply as soon as possible — early applications are often reviewed first.
Workers Compensation - Claims Adjuster | HYBRID | Riverside, CA
sedgwick · 💰 USD 65K–85K
You'll be redirected to sedgwick's official application page on Workday.