Claims Associate - Workers Compensation | Ontario, CA

Claims Associate – Workers Compensation Location: Ontario, California Primary Purpose: To analyze low‑level 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 Adjust medical‑only claims and minor lost‑time workers' compensation claims under close supervision. Support other claims representatives, examiners, and leads with larger or more complex claims as necessary. Process workers' compensation claims to determine compensability and benefits due; monitor reserve accuracy and file necessary documentation with state agencies. Communicate claim action/processing with claimants, clients, and appropriate medical contacts. Ensure claim files are properly documented and claims coding is correct. Process routine payments and prescriptions, and status reports for lifetime medical claims and/or defined‑period medical claims. Maintain professional client relationships. Additional Functions and 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 (1) year of general office experience or equivalent combination of education and experience required. Claims‑industry experience preferred. Benefits and Work Environment Flexible work schedule. Referral incentive program. Career development and promotional growth opportunities. Diverse and comprehensive benefits offering including medical, dental, vision, 401(k), paid time off, disability and life insurance, employee assistance, flexible spending or health savings account, and additional voluntary benefits. EEO & Fair Chance Statement All qualified applicants receive consideration for employment irrespective of race, color, religion, sex, national origin, disability, veteran status, or any other protected characteristic, in compliance with applicable laws. Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance, 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. Company Commitment Sedgwick is an Equal Opportunity Employer and a Drug‑Free Workplace. For more, see sedgwick.com #J-18808-Ljbffr