Job Description

Overview

By joining Sedgwick, you'll be part of something truly meaningful. Its 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, theres no limit to what you can achieve.

Newsweek Recognizes Sedgwick as Americas Greatest Workplaces National Top Companies

Certified as a Great Place to Work

Fortune Best Workplaces in Financial Services & Insurance

Claims Adjuster - Workers Compensation - Telecommute CA

Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the worlds best brands?

Responsibilities

• Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
• Leverage Sedgwicks broad, global network of experts to both learn from and to share your insights.
• Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.
• Enjoy flexibility and autonomy in your daily work, your location, and your career path.
• Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.
• Manages workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.
• Develops and manages workers compensation claims' action plans to resolution, coordinates return-to-work efforts and approves claim payments.
• Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.
• Manages subrogation of claims and negotiates settlements.
• Communicates claim action with claimant and client.
• Ensures claim files are properly documented, and claims coding is correct.
• May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
• Maintains professional client relationships.

Taking care of you

• Flexible Work Schedule
• Referral Incentive Program
• Opportunity to work from home
• Career development and promotional growth opportunities
• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day 1

Qualifications & Licensing

Education & Experience: Bachelor's degree from an accredited college or university preferred.

Experience: Four (4) years of claims management experience or equivalent combination of education and experience required.

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.

Sedgwick is the worlds leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The companys expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see sedgwick.com

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