Workers Compensation Claims Associate | Orange, CA

Workers Compensation Claims Associate

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

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 and/or virtual setting

• 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

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 Responsibilities 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 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

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 $22.00/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.

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.

If you're excited about this role but your experience doesn't 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.