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Workers Compensation Case Management Senior I

Sempra

San Diego, California, United States · senior

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San Diego, California, United States
Location
Senior
Seniority
Sempra
Employer

SDG&E is not just an energy company, we are the architects of a brighter, cleaner future. Our employees power everyday life for 3.7 million people – bringing the energy to support their passions, ambitions, and the heartbeat of our community. We call Southern California our home. It’s where we chase our dreams and raise our families. That’s why the people who live here deserve an energy company unlike any other, and that’s why every day, SDG&E employees strive to be at the forefront of innovations to reduce emissions, modernize the electric grid, and enable our customers to make the transition to clean technologies.

We’re redefining sustainability, advancing zero-emissions solutions, and driving the electric vehicle revolution. It takes the best to build the best – join us! Career Level: P3 Primary Purpose: Manages the end-to-end handling of standard workers' compensation claims, applying judgment to resolve issues and maintain compliance. Drives timely resolution and cost control through proactive communication and accurate case evaluation.

Duties and Responsibilities: Administers various aspects of the claim file handling of both in-house and third-party administered claims through diligent investigation and assessment. Evaluates completed investigation and case facts to determine merits of each claim. Performs pre and post binding claim audits as needed and communicate the audit results to appropriate internal and external stakeholders.

Assesses damages by calculating applicable damages or the range permitted by law; anticipates and understands settlement impacts and proactively addresses issues. Negotiates claim settlements using a negotiation strategy established by management as well as using available tools and resources within authority limits. Sets and reviews reserves promptly throughout the claims cycle within authority limits, including estimating and validating claim values.

Reviews and assists subject matter experts with development of testimony, work papers and discovery responses, settlement documents and communications materials. Ensures an efficient records maintenance system for workers' compensation claims and related information, data, and activities. Performs other duties as assigned.

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