Workers Compensation Claims Associate

Sedgwick • Ontario, CA

272d • $20 - $30

About The Position

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive. A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work. Great Place to Work® Most Loved Workplace® Forbes Best-in-State Employer Workers Compensation Claims Associate.

Requirements

• High school diploma or GED required.
• Licenses as required.
• One (1) year of general office experience or equivalent combination of education and experience required.
• Claims industry experience preferred.
• Excellent oral and written communication skills.
• PC literate, including Microsoft Office products.
• Analytical and interpretive skills.
• Strong organizational skills.
• Good interpersonal skills.
• Ability to work in a team environment.
• Ability to meet or exceed Performance Competencies.

Responsibilities

• Analyzes reported lower-level workers compensation claims to determine benefits due.
• Ensures ongoing adjudication of claims within company standards and industry best practices.
• 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.

Benefits

• Medical insurance
• Dental insurance
• Vision insurance
• 401k and matching
• PTO
• Disability insurance
• Life insurance
• Employee assistance program
• Flexible spending or health savings account
• Other additional voluntary benefits

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Insurance Carriers and Related Activities
• Education Level: High school or GED