Current jobs related to Claims Analyst - Ontario, California - Sedgwick

At Sedgwick, we prioritize the well-being of our team members, ensuring that you, our esteemed colleague, are well taken care of.

A career with us embodies a culture of compassion and support. It offers the flexibility to balance your personal and professional life, allowing you to engage in meaningful work every day. We are committed to addressing your mental, physical, financial, and professional needs, while also providing opportunities for skill enhancement and career advancement. Our environment is one that values diversity and inclusivity, fostering a sense of belonging for all.

Joining Sedgwick means aligning your passion with purpose, making a positive impact on the lives of individuals and organizations we serve.

If you are motivated to create change, enjoy tackling challenges, and genuinely care about others, you will find a welcoming space here.

**Position Overview:**
As a Claims Analyst, your primary responsibility will be to evaluate lower-level workers' compensation claims to ascertain the benefits owed, ensuring that claims are managed in accordance with company standards and industry best practices.

**Key Responsibilities:**
- Assess medical-only claims and minor lost-time workers' compensation claims under close supervision.
- Assist other claims representatives and examiners with more complex claims as needed.
- Process workers' compensation claims to determine compensability and benefits due; ensure reserve accuracy and file necessary documentation with the relevant state agency.
- Communicate claim actions and processing updates with claimants, clients, and medical contacts.
- Ensure proper documentation of claim files and accurate claims coding.
- May handle routine payments and prescriptions for lifetime medical claims or defined period medical claims.
- Maintain professional relationships with clients.

**Additional Responsibilities:**
- Perform other assigned duties.
- Support the organization's quality assurance programs.

**Qualifications:**
**Education & Licensing:**
- High school diploma or GED required; licenses as necessary.
**Experience:**
- Minimum of one (1) year of general office experience or an equivalent combination of education and experience required; claims industry experience preferred.
**Skills & Knowledge:**
- Exceptional oral and written communication skills.
- Proficient in PC usage, including Microsoft Office applications.
- Strong analytical and interpretive abilities.
- Excellent organizational skills.
- Good interpersonal skills.
- Ability to thrive in a team-oriented environment.
- Capacity to meet or exceed performance competencies.

**Work Environment:**
Consideration will be given to reasonable accommodations when applicable and appropriate.

**Mental Requirements:**
Ability to think clearly and conceptually; exercise excellent judgment, problem-solving, and analytical skills; manage work-related stress; handle multiple priorities simultaneously; and meet deadlines.

**Physical Requirements:**
Proficient in computer keyboarding; travel as required.

**Auditory/Visual Requirements:**
Ability to hear, see, and communicate effectively.

**Note:**
Credit security clearance, confirmed via a background credit check, is a requirement for this position.

The information provided in this document is intended to outline the general nature and level of work performed by a colleague in this role. It is not intended to be an exhaustive list of functions, duties, or local variations. Management retains the discretion to modify the duties of the position at any time.

As mandated 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 various factors, including skill set, experience level, and location.

A comprehensive benefits package is available, including but not limited to medical, dental, vision, 401k with matching, PTO, disability and life insurance, employee assistance programs, flexible spending or health savings accounts, and other voluntary benefits.

Sedgwick is an Equal Opportunity Employer and maintains a Drug-Free Workplace.

If you are enthusiastic about this opportunity but feel your experience does not perfectly match every qualification, we encourage you to apply anyway. Sedgwick is committed to building a diverse, equitable, and inclusive workplace, recognizing that each individual brings a unique combination of skills, knowledge, and experience.

You may be the ideal candidate for this or other positions.

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