Claims Specialist - Workers' Comp (On-Site)

Sedgwick; Riverside (CA); On-site; USD 34,000 - 39,000; Full time

Benefits offered by this job

Flexible schedule

Referral program

Career growth and development

Medical benefits

Dental benefits

Vision benefits

401K on day one

PTO

Job summary

Sedgwick in California is seeking a Claims Representative for Workers Compensation to adjudicate low-level claims and determine benefits in line with company standards and industry best practices.

You will join a global leader known for patient-focused service, with opportunities for professional growth and a flexible benefits package. This in-office role emphasizes accuracy, collaboration, and client communication.

Qualifications

• High school diploma or GED required.
• One year of general office experience or equivalent 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.

Education

High school diploma or GED

Job description

Sedgwick in California is seeking a Claims Representative for Workers Compensation to adjudicate low-level claims and determine benefits in line with company standards and industry best practices.

You will join a global leader known for patient-focused service, with opportunities for professional growth and a flexible benefits package. This in-office role emphasizes accuracy, collaboration, and client communication.