Claims Associate - Workers Compensation

$57,595 - $57,595/Yr

Sedgwick - Pasadena, CA

Full-time - Entry Level

Pasadena, CA

Insurance Carriers and Related Activities

About the position

The Claims Associate - Workers Compensation role at Sedgwick involves analyzing lower-level workers compensation claims to determine benefits due and ensuring ongoing adjudication of claims within company standards and industry best practices. This position emphasizes a culture of caring, flexibility, and support for employees' mental, physical, financial, and professional needs, while also promoting diversity and inclusion in the workplace.

Responsibilities

• Adjusts medical-only claims and minor lost-time 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.

Requirements

• High school diploma or GED required.
• One (1) year of general office experience or equivalent combination of education and experience required.
• Claims industry experience preferred.
• 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.

Benefits

• 401(k) matching
• Dental insurance
• Disability insurance
• Health insurance
• Health savings account
• Life insurance
• Paid time off