Description
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're looking for a Work Comp Claims Services Associate to join our team in Sacramento, CA. This is a hybrid role, with 2 days in the office and 3 days working from home.
Primary Purpose of the Role: The Claims Services Associate will work closely with Workers' Compensation Program Managers to receive, review, and document California workers' compensation information. You'll communicate regularly with medical facilities, third-party administrators, clients, and staff to move workers' compensation claims toward resolution.
Essential Responsibilities May Include:
- Provides initial research/data collection on claims file
- Performs file audits according to jurisdictional standards
- Reviews prior audit results, settled files, or files with no activity and identifies exceptions
- Coordinates file retrieval and gathers data for submittal to management
- Communicates with claim examiners to correct identified deficiencies
- Monitors correction of audit exceptions ensuring completion and assists with filing of state forms and submitting payments as necessary
- Researches exceptions on the state's quarterly compliance report and provides detailed response to management identifying trends in audit exceptions
- Reviews and updates notes/diaries in claims management system as instructed
- Coordinates jurisdictional training on state specific tools
- Performs other duties as assigned
- Supports the organisation's quality program(s)
Qualifications:
- 2 years of claims experience or equivalent combination of education and experience required
- High school diploma or GED required
- Knowledge of state workers' compensation statute
- Proficient math skill
- Skilled with Excel spreadsheets
- Excellent oral and written communication, including presentation skills
- PC literate, including Microsoft Office products
- Ability to work in a team environment
- Ability to meet or exceed Performance Competencies
Work Environment Requirements:
- Physical: Computer keyboarding
- Auditory/visual: Hearing, vision and talking
- Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines
Salary: $25.00-$30.00 USD hourly
Benefits: A comprehensive benefits package is offered, including medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.