Claims Associate Workers Compensation In-Office - Long Beach CA

Taking care of people is at the heart of everything we do and we start by taking care of you our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. Its an opportunity to do something meaningful each and every day. Its having support for your mental physical financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference who enjoys a challenge and above all if youre someone who cares theres a place for you here. Join us and contribute to Sedgwick being a great place to work.

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PRIMARY PURPOSE:To analyze reported lowerlevel workers compensation claims to determine benefits due; and to ensure ongoing adjudication of claims within company standards and industry best practices.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Adjusts medicalonly claims and minor losttime 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.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.
• Supports the organizations quality program(s).

QUALIFICATION

Education & Licensing
High school diploma or GED required. Licenses as required.

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

Skills & Knowledge

• Excellent oral and written communication skills
• PC literate including Microsoft Office products
• Analytical and interpretive skills
• Strong organizational skills
• Good interpersonal 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 workrelated 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 $2028/hr)(bonus eligibility if applicable). 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.

Sedgwickis an Equal Opportunity Employer and a DrugFree Workplace.

If youre excited about this role but your experience doesnt align perfectly with every qualification in the job description consider applying for it anyway! Sedgwick is building a diverse equitable and inclusive workplace and recognizes that each person possesses a unique combination of skills knowledge and experience. You may be just the right candidate for this or other roles.