Claims Associate - Workers Compensation (IN-OFFICE Concord, CA)
Sedgwick, Concord, CA, United States
Claims Associate – Workers Compensation (IN‑OFFICE, Concord, CA)
Primary purpose: To analyze low‑level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices.
Essential Functions & Responsibilities
Adjust medical‑only and minor lost‑time workers compensation claims under close supervision.
Support claims representatives, examiners, and leads with larger or more complex claims as necessary.
Process workers compensation claims, determining compensability and benefits due; monitor reserve accuracy and file necessary documentation with the state agency.
Communicate claim action/processing with claimant, client, and appropriate medical contact.
Ensure 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.
Maintain professional client relationships.
Additional Functions & Responsibilities
Perform other duties as assigned.
Support the organization’s quality program(s).
Travel as required.
Qualifications
Education & Licensing : High school diploma or GED; required licenses as applicable.
Experience : One year of general office experience or an equivalent combination of education and experience; claims industry experience preferred.
Taking Care of You
Flexible work schedule.
Referral incentive program.
Career development and promotional growth opportunities.
Diverse and comprehensive benefits offering including medical, dental, vision, 401(k) on day one.
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. For the jurisdiction noted in this posting, the starting pay for this role is $25/hr. A comprehensive benefits package is offered including medical, dental, vision, 401(k) and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other 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.
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Primary purpose: To analyze low‑level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices.
Essential Functions & Responsibilities
Adjust medical‑only and minor lost‑time workers compensation claims under close supervision.
Support claims representatives, examiners, and leads with larger or more complex claims as necessary.
Process workers compensation claims, determining compensability and benefits due; monitor reserve accuracy and file necessary documentation with the state agency.
Communicate claim action/processing with claimant, client, and appropriate medical contact.
Ensure 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.
Maintain professional client relationships.
Additional Functions & Responsibilities
Perform other duties as assigned.
Support the organization’s quality program(s).
Travel as required.
Qualifications
Education & Licensing : High school diploma or GED; required licenses as applicable.
Experience : One year of general office experience or an equivalent combination of education and experience; claims industry experience preferred.
Taking Care of You
Flexible work schedule.
Referral incentive program.
Career development and promotional growth opportunities.
Diverse and comprehensive benefits offering including medical, dental, vision, 401(k) on day one.
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. For the jurisdiction noted in this posting, the starting pay for this role is $25/hr. A comprehensive benefits package is offered including medical, dental, vision, 401(k) and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other 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.
#J-18808-Ljbffr