Claims Associate, Workers’ Compensation — Flexible Schedule

Sedgwick Claims Management Services Ltd; Riverside, Iowa (CA, LA); On-site; USD 34,000 - 39,000; Full time

Benefits offered by this job

Medical

Dental

Vision

401K

PTO

Disability Insurance

Life Insurance

Employee Assistance

FSA/HSA

Job summary

Sedgwick is seeking a Claims Representative - Workers’ Compensation for an in-office role in Ontario or Riverside, California. You will analyze low level workers’ compensation claims to determine benefits due and drive adjudication within company standards and industry best practices.

You’ll support other representatives on larger claims, communicate with claimants and clients, and maintain accurate documentation.

Qualifications

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

Education

High school diploma or GED

Job description

Sedgwick is seeking a Claims Representative - Workers’ Compensation for an in-office role in Ontario or Riverside, California. You will analyze low level workers’ compensation claims to determine benefits due and drive adjudication within company standards and industry best practices.

You’ll support other representatives on larger claims, communicate with claimants and clients, and maintain accurate documentation.