Workers Compensation Claims Associate | Orange, CA

Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career?

• A stable and consistent work environment in an office

• Career development and promotional growth opportunities through increasing responsibilities

• A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs

ARE YOU AN IDEAL CANDIDATE? We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

OFFICE LOCATIONS
Orange, California (On-site)

PRIMARY PURPOSE OF THE ROLE: Analyze reported lower-level workers compensation claims to determine benefits eligibility and ensure ongoing adjudication aligns with company standards and industry best practices.

ESSENTIAL RESPONSIBLITIES MAY INCLUDE

• Handles medical-only and minor lost-time workers compensation claims under supervision.

• Assists senior claims staff with complex cases as needed.

• Determines compensability and benefits; ensures reserve accuracy and files required documentation.

• Communicates claim status with claimants, clients, and medical contacts.

• Maintains accurate documentation and correct claims coding.

• Processes routine payments, prescriptions, and status reports for ongoing medical claims.

• Builds and maintains professional client relationships.

QUALIFICATIONS

Education & Licensing: 1 year of general office experience or equivalent combination of education and experience required. Claims industry experience preferred.

• High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred. 

• Professional certification as applicable to line of business preferred.

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
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 $22-$24/hr. 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.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.