Workers' Comp Claims Associate - On-Site CA

Sedgwick Claims Management Services Ltd; Rancho Cordova (CA); On-site; USD 30,000 - 34,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development and promotional增长

Comprehensive benefits including medis

Job summary

Sedgwick is seeking a Claims Associate - Workers Compensation in Rancho Cordova, CA or Orange, CA to analyze reported lower level claims and determine benefits due, ensuring adjudication within company standards.

The role supports claims processing, communicates with claimants and clients, maintains accurate files, and collaborates with colleagues to handle routine and more complex cases on an on-site basis.

Qualifications

• High school diploma or GED is required.
• One year of general office experience is required; claims industry experience is a plus.

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.

Skills

Office experience

Education

High school diploma or GED

Job description

Sedgwick is seeking a Claims Associate - Workers Compensation in Rancho Cordova, CA or Orange, CA to analyze reported lower level claims and determine benefits due, ensuring adjudication within company standards.

The role supports claims processing, communicates with claimants and clients, maintains accurate files, and collaborates with colleagues to handle routine and more complex cases on an on-site basis.