📌 Core Information
🔹 Job Title: Workers Compensation | Claims Examiner | Dedicated Account | Hybrid - Orange, CA
🔹 Company: Sedgwick
🔹 Location: Orange, CA
🔹 Job Type: Full-Time
🔹 Category: Insurance
🔹 Date Posted: July 2, 2025
🔹 Experience Level: 5-10 years
🔹 Remote Status: Hybrid
🚀 Job Overview
Key aspects of this role include:
- Adjudicating complex customer claims in an energetic culture
- Delivering innovative customer-facing solutions to clients
- Working for a global industry leader with a rapidly growing network
- Enjoying flexibility and autonomy in daily work, location, and career path
ASSUMPTION: This role requires strong analytical skills, attention to detail, and the ability to work independently while managing multiple cases.
📋 Key Responsibilities
✅ Analyze and process claims through well-developed action plans to an appropriate and timely resolution
✅ Negotiate settlement of claims within designated authority
✅ Communicate claim activity and processing with the claimant and the client
✅ Report claims to the excess carrier and respond to requests of directions in a professional and timely manner
ASSUMPTION: The role involves a high degree of autonomy and requires strong organizational skills to manage multiple cases effectively.
🎯 Required Qualifications
Education: High School Diploma or GED required, Bachelor's degree preferred
Experience: 5 years of claims management experience or equivalent combination of education and experience required
Required Skills:
- Proven experience in claims management
- Strong analytical and problem-solving skills
- Excellent communication skills, both written and verbal
- Ability to work independently and manage multiple cases
- Familiarity with workers' compensation claims and regulations
Preferred Skills:
- Professional certification as applicable to line of business
- Experience with Sedgwick's claims management system
- Bilingual or multilingual skills
ASSUMPTION: While not explicitly stated, proficiency in English is likely required for this role due to the nature of the work and the location.
💰 Compensation & Benefits
Salary Range: $85,000 - $95,000/yr (based on the provided range and industry standards for the role, experience level, and location)
Benefits:
- Medical, dental, vision
- 401K on day one
- PTO
- Disability and life insurance
- Employee assistance
- Flexible spending or health savings account
- Other additional voluntary benefits
Working Hours: Full-time, with a flexible work schedule
ASSUMPTION: The salary range provided is an estimate based on the information given and industry standards for the role, experience level, and location. Actual compensation may vary based on various factors.
📌 Applicant Insights
🔍 Company Context
Industry: Sedgwick operates in the insurance industry, specializing in claims management, risk management, and other related services.
Company Size: Sedgwick is a large company with over 33,000 employees globally, providing a diverse and dynamic work environment.
Founded: Sedgwick was founded in 1969 and has since grown into a global leader in its industry.
Company Description:
- Sedgwick is the world’s leading risk and claims administration partner, helping clients thrive by navigating the unexpected.
- The company’s expertise, combined with advanced AI-enabled technology, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall.
- Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape.
Company Specialties:
- Claims management
- Risk management
- Workers' compensation
- Disability
- Absence solutions
- Affinity
- First and third-party fleet programs
- Healthcare risk management
- Retail and consumer care services
- Integrated services
- Managed care
- Property
- Casualty
- Benefits
- Marine
- Integrated
- Technology
- Liability
- Loss adjusting
- Compliance
- Loss prevention
- And cat response
Company Website: sedgwick.com
ASSUMPTION: Sedgwick's global presence and extensive expertise in the industry offer applicants a unique opportunity to grow both personally and professionally.
📊 Role Analysis
Career Level: This role is suitable for experienced professionals looking to advance their careers in claims management.
Reporting Structure: The Claims Examiner role reports directly to the Claims Manager or Supervisor.
Work Arrangement: This is a hybrid role, requiring employees to work on-site in Orange, CA, and remotely.
Growth Opportunities:
- Sedgwick offers a variety of professional development opportunities to help employees grow their careers.
- The company's global network provides ample opportunities for learning and sharing insights with experts in the field.
- With over 10,000 clients across 80 countries, Sedgwick offers diverse and challenging projects to work on.
ASSUMPTION: Given Sedgwick's size and global presence, there are likely numerous opportunities for career advancement and growth within the company.
🌍 Location & Work Environment
Office Type: Hybrid - Orange, CA
Office Location(s): Orange, CA
Geographic Context:
- Orange, CA, is located in Southern California, approximately 30 miles southeast of Los Angeles.
- The city offers a mix of urban and suburban environments, with a population of around 140,000 people.
- The area is known for its mild Mediterranean climate, with warm, dry summers and mild, wet winters.
Work Schedule: Full-time, with a flexible work schedule
ASSUMPTION: The hybrid work arrangement allows for a better work-life balance, as employees can work remotely for part of the week.
💼 Interview & Application Insights
Typical Process:
- Online application submission
- Phone or video screening
- In-person or virtual interview with the hiring manager
- Background check and reference verification
- Job offer
Key Assessment Areas:
- Claims management experience
- Analytical and problem-solving skills
- Communication skills
- Attention to detail
- Ability to work independently
Application Tips:
- Highlight relevant claims management experience and achievements in your resume.
- Tailor your cover letter to demonstrate your understanding of the role and your fit with Sedgwick's company culture.
- Prepare for behavioral interview questions that focus on your problem-solving skills, communication, and attention to detail.
ATS Keywords: Claims management, workers' compensation, claims examiner, dedicated account, hybrid, Orange, CA
ASSUMPTION: Sedgwick uses an Applicant Tracking System (ATS) to manage job applications, so including relevant keywords in your resume can help improve your chances of being selected for an interview.
🛠️ Tools & Technologies
- Sedgwick's claims management system
- Microsoft Office Suite (Word, Excel, PowerPoint)
- Email and calendar tools (e.g., Outlook, Gmail)
- Video conferencing tools (e.g., Zoom, Microsoft Teams)
ASSUMPTION: Familiarity with Sedgwick's claims management system and relevant software tools is likely required for this role.
👔 Cultural Fit Considerations
Company Values:
- Empathy
- Accountability
- Collaboration
- Growth
- Inclusion
Work Style:
- Autonomous and self-motivated
- Strong attention to detail
- Excellent communication skills
- Ability to manage multiple cases effectively
Self-Assessment Questions:
- Do you have strong analytical and problem-solving skills?
- Are you comfortable working independently and managing multiple cases?
- Do you thrive in a dynamic and fast-paced environment?
ASSUMPTION: Applicants who align with Sedgwick's company values and work style are more likely to succeed in this role and enjoy a better fit with the company culture.
⚠️ Potential Challenges
- The role may require handling sensitive and complex claims, which can be emotionally taxing at times.
- Working in a hybrid environment may present unique challenges in terms of communication and collaboration with on-site and remote colleagues.
- The workload may fluctuate depending on the volume of claims, requiring strong time management and organizational skills.
- The role may involve working with tight deadlines and service expectations, which can be stressful at times.
ASSUMPTION: Applicants should be aware of these potential challenges and consider how they would approach them in the context of this role.
📈 Similar Roles Comparison
- This role is similar to other claims examiner positions, but it offers the unique advantage of working for a global industry leader with a rapidly growing network.
- Sedgwick's size and global presence provide opportunities for career growth and development that may not be available in smaller organizations.
- While the core responsibilities of this role are similar to other claims examiner positions, the specific requirements and work environment may vary depending on the company and industry.
ASSUMPTION: Applicants should research other claims examiner roles and consider how this position compares in terms of company size, industry, and career growth opportunities.
📝 Sample Projects
- Analyzing and processing a complex workers' compensation claim, including gathering information, determining exposure, and negotiating settlement.
- Developing and implementing a claims management strategy for a new client, including customizing service expectations and industry best practices.
- Collaborating with a multidisciplinary team to resolve a high-profile, high-exposure claim, ensuring all parties are satisfied with the outcome.
ASSUMPTION: These sample projects are intended to give applicants an idea of the types of tasks they may encounter in this role, but the specific projects and responsibilities may vary depending on the company and industry.
❓ Key Questions to Ask During Interview
- Can you describe the typical caseload for this role and how it may vary over time?
- How does Sedgwick support the professional development and growth of its claims examiners?
- What is the company culture like, and how does it foster collaboration and innovation?
- How does Sedgwick ensure that its claims examiners have the resources and support they need to succeed in their roles?
- What are the most challenging aspects of this role, and how can I best prepare for them?
ASSUMPTION: These questions are designed to help applicants better understand the role, the company culture, and the expectations for success in this position.
📌 Next Steps for Applicants
To apply for this position:
- Submit your application through the Sedgwick careers page.
- Tailor your resume to highlight your relevant claims management experience and achievements.
- Write a cover letter that demonstrates your understanding of the role and your fit with Sedgwick's company culture.
- Prepare for the interview by researching Sedgwick and practicing your responses to common interview questions.
- Follow up with the hiring manager after the interview to express your interest in the role and reiterate your qualifications.
⚠️ This job description contains AI-assisted information. Details should be verified directly with the employer before making decisions.
