Workers Compensation - Claims Associate | Orange, CA

Sedgwick; Orange (CA); On-site; USD 30,000 - 33,000; Full time

Benefits offered by this job

Flexible schedule

Referral incentive program

Career development

Benefits package (medical, dental, 401

K on day one

Job summary

Sedgwick in Orange, CA is hiring a Claims Associate to analyze reported lower-level general liability claims and ensure timely adjudication under company standards. You will support ongoing claim handling with supervision and collaborate with clients and medical contacts as needed.

The role requires at least a high school diploma or GED and one year of general office experience, with a preference for prior claims experience.

Qualifications

• High School Diploma or GED required.
• 1 year of general office experience or equivalent combination of education and experience.
• Claims industry experience preferred.

Responsibilities

• Analyzes lower-level liability and/or physical damage claims under close supervision.
• Supports other claims representatives, examiners and leads with larger or more complex claims as necessary.
• Processes general liability claims determining compensability and benefits due; monitors reserve accuracy and files documentation with state agency.
• Communicates claim actions with claimants, clients and appropriate medical contacts.
• Ensures claim files are properly documented and claims coding is correct.
• May process routine payments and status reports for lifetime medical or defined period medical claims.

Skills

General office experience

Claims experience

Education

High School Diploma or GED

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

Workers Compensation - Claims Associate | Orange, CA

WORK LOCATION: Orange, CA (On-Site)

PRIMARY PURPOSE OF THE ROLE

To analyze reported lower-level level general liability claims to determine benefits due; and to ensure ongoing adjudication of claims within company standards and industry best practices.

Essential Responsiblities May Include

• Handles lower-level liability and/or physical damage claims under close supervision.
• Supports other claims representatives, examiners and leads with larger or more complex claims as necessary.
• Processes general liability 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, performs other duties as assigned and supports the organization's quality program(s).

Qualifications

Education & Licensing: High School Diploma or GED required.

Experience: One (1) year of general office experience or equivalent combination of education and experience required. Claims industry experience preferred.

Licensing / Jurisdiction Knowledge:

TAKING CARE OF YOU

• Flexible work schedule.
• Referral incentive program.
• Career development and promotional growth opportunities.
• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

Work Environment Requirements Include

• 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
• Auditory/Visual: Hearing, vision and talking

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 $22.00-$24.00 per hour. 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.