Comp Claims Services Associate | Hybrid | Sacramento, CA

Position: Work Comp Claims Services Associate | Hybrid | Sacramento, CA
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 Work Comp Claims Services Associate | Hybrid | Sacramento, CAAre you looking for an impactful job that offers an opportunity to develop a professional career?

This role is hybrid 2 days in the Sacramento, CA Sedgwick office and 3 days' work at home
* Career development and promotional growth opportunities through increasing responsibilitiesA diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs PRIMARY PURPOSE OF

THE ROLE:

The Claims Services Associate is an important part of the services provided as they work closely with the Workers’ Compensation Program Managers to receive, review, and document California workers’ compensation information as directed. The Associate communicates regularly when needed with medical facilities, third-party administrators, clients, and staff. With the Associate’s skills and knowledge, the Associate will review documents and other third-party administrator’s claims system to make recommendations when needed to staff that will 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 as directed by state, carrier, or client.

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 by provides corrected payment amount and instructions regarding necessary state form filing.

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 organization's quality program(s).QUALIFICATIONS Education & Licensing:
Two (2) years of claims experience or equivalent combination of education and experience required.

High school diploma or GED required.

Skills & Knowledge Knowledge of state workers' compensation statute

Proficient math skill

Skilled with Excel spreadsheets

Excellent oral and written communication, including presentation skillsPC literate, including Microsoft Office products

Ability to work in a team environment

Ability to meet or exceed Performance Competencies Work environment requirements include –Physical:
Computer keyboarding

Auditory/visual:
Hearing, vision and talking

Mental:
Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.

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 $25.00- $30.00…