Workers Compensation | Claims Representative (Future Medical)| In-Office (Concord, CA) job opportunity at Sedgwick.

Home Jobs In United States Of America Tag: CA) Workers Compensation | Claims Representative (Future Medical)| In-Office (Concord, CA) position at Sedgwick


DateMore Than 30 Days Ago bot
Sedgwick Workers Compensation | Claims Representative (Future Medical)| In-Office (Concord, CA)
Experience: General
Pattern: full-time
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Status:

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degreeBachelor's (B.A.)
loacation Concord, CA, United States Of America
loacation Concord, CA....United States Of America

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 Workers Compensation | Claims Representative (Future Medical)| In-Office (Concord, CA) ARE YOU AN IDEAL CANDIDATE? 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 Concord, CA (In Office 5 days per week)   PRIMARY PURPOSE : To process low level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements with general supervision. ESSENTIAL FUNCTIONS and RESPONSIBILITIES Processes low level 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 coordinates low level workers compensation claims' action plans to resolution, return-to-work efforts, and approves claim payments. Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract. Administers 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 low-level 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.  ADDITIONAL FUNCTIONS and RESPONSIBILITIES Performs other duties as assigned. Supports the organization's quality program(s). Travels as required. QUALIFICATIONS Education & Licensing Bachelor's degree from an accredited college or university preferred. Experience Two (2) years of claims management experience or equivalent combination of education and experience or successful completion of Claims Representative training required. Skills & Knowledge Developing knowledge of regulations, offsets and deductions, disability duration, medical management practices and Social Security and Medicare application procedure as applicable to line of business Excellent oral and written communication, including presentation 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 Service Expectations WORK ENVIRONMENT 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, travel as required 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 ( 25 - $27.69 ). 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.  #claimsrepresentaive 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.

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