Return to Work Representative

Sedgwick; Fallbrook (CA); On-site; USD 55,000 - 77,000; Full time

Job summary

Sedgwick in California is seeking a Return to Work Representative to coordinate and monitor successful RTW for claimants within disability guidelines. You’ll partner with clients, treatment providers and claimants to negotiate accommodations and document decisions in line with policies.

You will work closely with case management and employers to identify job requirements, physical demands and training needs, ensuring timely placements and compliant communications across all stakeholders.

Qualifications

• Experience with return-to-work or job accommodation processes.
• Strong communication, both written and oral, and documentation skills.
• Ability to work with multiple stakeholders including clients and providers.

Responsibilities

• Determines objective, quantifiable, medically supported work restrictions.
• Facilitates RTW and accommodation via negotiation with client, provider, and claimant; documents all related information.
• Ensures compliance with medical, legal, and accreditation standards in communications.
• Contacts employers to gather information on job requirements and physical demands.
• Maintains regular contact with clients post-placement and supports transition to job placement.

Skills

Return-to-work procedures

Claims management procedures

Oral and written communication

Negotiation skills

Team collaboration

Education

HS Diploma/GED

Bachelor’s degree preferred

Tools

Microsoft Office

Job description

By joining Sedgwick, you’ll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve.

Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies

Certified as a Great Place to Work®

Fortune Best Workplaces in Financial Services & Insurance

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.

Sedgwickis an Equal Opportunity Employer and a Drug-Free Workplace.