Claims Associate - Workers Compensation (IN-OFFICE Concord, CA)

Sedgwick • Concord, CA

7d • Onsite

About The Position

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. This role offers an opportunity to join a global industry leader where you can bring your ideas to help solve problems for some of the world’s best brands. You will apply your knowledge and experience to adjudicate complex customer claims in an energetic culture, delivering innovative customer-facing solutions to clients across various industries. Sedgwick is a rapidly growing, industry-leading global company known for its excellence and customer service. You will leverage Sedgwick’s broad, global network of experts for learning and sharing insights, and take advantage of professional development opportunities to grow your career. The position offers flexibility and autonomy in daily work, location, and career path, along with diverse and comprehensive benefits for mental, physical, financial, and professional needs. The primary purpose of this role is to analyze low-level workers' compensation claims to determine benefits due and to ensure ongoing adjudication of claims within company standards and industry best practices.

Requirements

• High school diploma or GED
• Licenses as required
• One (1) year of general office experience or equivalent combination of education and experience required.

Nice To Haves

• Claims industry experience preferred.

Responsibilities

• Adjusts medical-only claims and minor lost-time workers compensation claims under close supervision.
• Supports other claims representatives, examiners and leads with larger or more complex claims as necessary.
• Processes workers compensation claims determining compensability and benefits due; monitors reserve accuracy, and files necessary documentation with state agency.
• Communicates claim action/processing with claimant, client and appropriate medical contact.
• Ensures claim files are properly documented and claims coding is correct.
• May process routine payments and prescriptions and status reports for lifetime medical claims and/or defined period medical claims.
• Maintains professional client relationships.
• Performs other duties as assigned.
• Supports the organization's quality program(s).
• Travels as required.

Benefits

• Flexible work schedule.
• Referral incentive program.
• Career development and promotional growth opportunities.
• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
• Medical insurance
• Dental insurance
• Vision insurance
• 401k and matching
• PTO
• Disability insurance
• Life insurance
• Employee assistance
• Flexible spending or health savings account
• Other additional voluntary benefits.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 251-500 employees