Workers Compensation Claims Associate | Orange, CA

Sedgwick•Orange, CA

1d•Onsite

About The Position

Analyze reported lower-level workers compensation claims to determine benefits eligibility and ensure ongoing adjudication aligns with company standards and industry best practices. This role offers an opportunity to develop a professional career with a stable and consistent work environment in an office and/or virtual setting, along with career development and promotional growth opportunities through increasing responsibilities. Sedgwick is looking for driven individuals that embody their caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

Requirements

1 year of general office experience or equivalent combination of education and experience required.
High School Diploma or GED required.
Computer keyboarding
Hearing, vision and talking

Nice To Haves

Claims industry experience preferred.
Bachelor's degree from an accredited college or university preferred.
Professional certification as applicable to line of business preferred.

Responsibilities

Handles medical-only and minor lost-time workers compensation claims under supervision.
Assists senior claims staff with complex cases as needed.
Determines compensability and benefits; ensures reserve accuracy and files required documentation.
Communicates claim status with claimants, clients, and medical contacts.
Maintains accurate documentation and correct claims coding.
Processes routine payments, prescriptions, and status reports for ongoing medical claims.
Builds and maintains professional client relationships.