Return to Work Representative

Sedgwick Claims Management Services Ltd; California; On-site; USD 37,000 - 51,000; Full time

Benefits offered by this job

Medical, dental, vision

401k and matching

PTO

Disability and life insurance

Flexible spending or health savings

Job summary

Sedgwick CMS is seeking a Return to Work Representative in California to negotiate and monitor successful RTW for claimants. You will determine medical work restrictions, coordinate with employers, providers and claimants, and document all activities per company standards.

The role requires a HS Diploma or GED, with a Bachelor's preferred, and 3 years of related experience including RTW or claims management. Strong communication and negotiation skills are essential.

Qualifications

• HS Diploma/GED required.
• Bachelor's degree from an accredited college or university preferred.
• Three (3) years of related experience including one (1) year of RTW or job accommodation experience or three (3) years of claims management experience.
• Excellent oral and written communications, including presentation skills.
• PC literate with ability to analyze and interpret information.

Responsibilities

• Determine objective, medically supported work restrictions for assigned claims.
• Facilitates return-to-work and accommodation through negotiation with client, provider and claimant; documents related entries.
• Contacts employers to gather job-related information and determine essential functions.
• Maintains regular client contact and monitors progress; suggests plan changes as needed.
• Works with team to ensure smooth transition from medical case management to job placement.

Skills

Communication

Analytical thinking

Organizational skills

Negotiation

Teamwork

Presentation skills

Education

HS Diploma/GED

Bachelor's degree preferred

Tools

Microsoft Office

Job description

Return to Work Representative**PRIMARY PURPOSE:** To negotiate, facilitate and monitor successful return-to-work of claimants within appropriate disability duration guidelines and to assist case management staff with client competence decisions for individual positions. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES*** Determines objective, quantifiable, medically supported work restrictions for assigned claims.* Facilitates return-to-work (RTW) and accommodation efforts through negotiation with client, treatment provider and claimant; completes all accommodation/RTW related jurisdictional or client directed documentation, notification, or reporting; and documents client contact in claim notes as per Sedgwick CMS standards.* Adheres to medical and legal regulations and accreditation standards in written communication.* Contacts employers to determine specific information regarding employment area (i.e. training/education needed, physical demands, wages and benefits, availability, etc.); ascertains the specific physical tolerances, vocational skills and essential job functions needed for specific employment positions as requested by referral sources or employers; and recommends necessary adaptive equipment as needed.* Maintains regular contact with clients following placement as per program guidelines, contacts involved individuals regarding progress on each case and makes suggestions as needed for changing plans.* Works closely with team members to ensure smooth transition from medical case management into job placement.* Performs other tasks related to accommodation/RTW evaluation and work adjustment as needed. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES*** Performs other duties as assigned. **QUALIFICATIONS** **Education & Licensing**HS Diploma/GED required. Bachelor's degree from an accredited college or university preferred. **Experience** Three (3) years of related experience including one (1) year of return-to-work or job accommodation experience or three (3) years of claims management experience or equivalent combination of education and experience required. **Skills & Knowledge*** Working knowledge of return-to work or job accommodation procedures* Good technical knowledge of claims management procedures* Excellent oral and written communications, including presentation skills* PC literate, including Microsoft Office products* Analytical and interpretive skills* Strong organizational skills* Excellent interpersonal skills* Excellent negotiation skills* Ability to work in a team environment* Ability to meet or exceed Performance Competencies **WORK ENVIRONMENT** When applicable and appropriate, consideration will be given to reasonable accommodations. **Mental:** Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines **Physical:** Computer keyboarding, travel as required **Auditory/Visual:** Hearing, vision and talking The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. *As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is* $26.55 - $37.18 USD Hourly*. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.* Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance, the San Diego Fair Chance Ordinance, the San Francisco Fair Chance Ordinance, the California Fair Chance Act, and all other applicable laws.Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.