Claims Specialist
2 weeks ago
Join Our Team as a Claims Specialist
At Sedgwick, we prioritize the well-being of our colleagues, ensuring a supportive and nurturing work environment. A career with us means embracing a culture of care, where flexibility and personal priorities are valued. It’s an opportunity to engage in meaningful work that makes a difference every day while receiving support for your mental, physical, financial, and professional needs. Here, you can enhance your skills and advance your career in a diverse and inclusive setting.
About Sedgwick
We are committed to making a positive impact on the world through our services to individuals and organizations. If you are passionate about making a difference and thrive on challenges, we welcome you to be part of our mission.
Position Overview
PRIMARY PURPOSE: To evaluate reported lower-level workers' compensation claims to ascertain the benefits owed and ensure ongoing claim management aligns with company standards and industry best practices.
KEY RESPONSIBILITIES:
- Manage 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, determining compensability and benefits due; ensure reserve accuracy and file necessary documentation.
- Communicate claim actions and processing updates with claimants, clients, and relevant medical contacts.
- Ensure proper documentation and coding of claim files.
- May handle routine payments and status reports for medical claims.
- Maintain professional relationships with clients.
- Perform other assigned duties.
- Support the organization's quality initiatives.
Education & Licensing
A high school diploma or GED is required. Relevant licenses as necessary.
Experience
One (1) year of general office experience or a combination of education and experience is required. Experience in the claims industry is preferred.
Skills & Knowledge:
- Strong oral and written communication abilities.
- Proficient in PC applications, including Microsoft Office.
- Analytical and interpretive skills.
- Excellent organizational capabilities.
- Interpersonal skills to foster teamwork.
- Ability to meet or exceed performance standards.
We consider reasonable accommodations when applicable.
Mental: Clear thinking, excellent judgment, problem-solving, and discretion; ability to manage work-related stress and multiple priorities.
Physical: Computer keyboarding and occasional travel as required.
Auditory/Visual: Hearing, vision, and verbal communication.
NOTE: A background credit check is required for this position.
At Sedgwick, we are an Equal Opportunity Employer and maintain a Drug-Free Workplace. We encourage individuals with diverse backgrounds to apply, recognizing that each person brings a unique set of skills and experiences that contribute to our success.
-
Healthcare Claims Specialist
2 weeks ago
Ontario, California, United States TotalMed Staffing Full timeHealthcare Claims Specialist About the Position As a vital member of our team, you will play a key role in ensuring the precise and prompt processing of healthcare claims. Position Details Compensation: $45.72 / hour Location: Ontario, California Profession: Claims Processing Facility Type: Healthcare Specialty: Health Insurance Division: MedFi Key...
-
Claims Adjuster
5 days ago
Ontario, California, United States Sedgwick Full timeAbout the RoleWe are seeking a highly skilled Claims Adjuster - Workers Compensation Specialist to join our team at Sedgwick. As a key member of our claims management team, you will be responsible for analyzing and managing workers compensation claims to ensure accurate and timely benefits are provided to our clients.Key ResponsibilitiesAnalyze and manage...
-
Claims Assessment Specialist
2 weeks ago
Ontario, California, United States NTT DATA Full timeAbout NTT DATA Services:At NTT DATA, we understand that the right talent is crucial for success. Our employees' dedication and integrity have been pivotal in our growth and market presence. By selecting top-tier professionals and fostering their development, we ensure a prosperous future for both NTT DATA and our workforce. For over 25 years, NTT DATA...
-
Claims Assessment Specialist
2 weeks ago
Ontario, California, United States NTT DATA Full timeAbout NTT DATA Services:At NTT DATA, we understand that with the right talent, we can achieve remarkable outcomes. The dedication, integrity, and quality of our workforce have been pivotal in our growth and market influence. By attracting top talent and fostering their professional and personal development, we secure a promising future for both NTT DATA and...
-
Medical Billing Specialist
4 days ago
Ontario, California, United States Marsell Wellness Center Full timeJob Title: Medical Billing SpecialistMarsell Wellness Center is seeking a highly skilled Medical Billing Specialist to join our team. As a Medical Billing Specialist, you will be responsible for handling billing processes, submitting claims to insurance companies, and following up on any outstanding invoices to ensure prompt payment.Key...
-
Insurance Fraud Investigation Specialist
2 weeks ago
Ontario, California, United States Kemper Full timeLocation: Ontario, CaliforniaCompany Overview:Kemper stands as a prominent name among specialized insurers in the nation. Our achievements are a testament to the skilled and diverse individuals who contribute positively to our customers' lives daily. We foster a high-performance culture that encourages personal growth, professional challenges, and a balanced...
-
Ontario, California, United States Mission Regional Medical Center Full timeOverviewMission Regional Medical Center is a prominent healthcare provider dedicated to delivering exceptional medical services. With a network of facilities and a commitment to patient care, we strive to enhance the health and well-being of our community. We are seeking talented individuals to join our corporate team.We are an Equal Opportunity Employer and...
-
Compensation Claims Specialist
2 weeks ago
Ontario, California, United States LanceSoft Full timeDescripción del Trabajo:Analizar reclamaciones de compensación laboral complejas o técnicamente difíciles para determinar los beneficios correspondientes; gestionar reclamaciones de alta exposición que involucren litigios y rehabilitación; asegurar la adjudicación continua de reclamaciones dentro de las expectativas de servicio, las mejores prácticas...
-
Warranty Admin
1 month ago
Ontario, California, United States Rise Technical Recruitment Ltd Full timeWarranty SpecialistOntario, CA$20 p/h+ Bonus + 401(k) + Training + Benefits Package + Progression + Healthcare Package + PTOAre you a recent Graduate or Customer Service Rep starting your career, looking to work for a company that offers industry leading training, progression and growth opportunity within a dynamic warehouse environment? On offer is the...
-
Litigation Specialist
7 days ago
Ontario, California, United States Liberty Mutual Full timeAbout the RoleWe are seeking a highly skilled Insurance Defense Attorney to join our team at Liberty Mutual. As a key member of our legal department, you will play a critical role in upholding and protecting our policyholders' rights.Key ResponsibilitiesManage the entire legal process, from investigation and discovery to trial preparation and court...
-
Insurance Solutions Specialist
7 days ago
Ontario, California, United States RRC Full timeJob OverviewWe are seeking a highly skilled and experienced Business Development Manager to join our team at RRC. As the Account Executive, Commercial Lines, you will be responsible for fostering client partnerships, delivering premium solutions, and driving business growth through strategic initiatives.Key Responsibilities:Assist clients in the claims...
-
Client Relations Specialist
2 weeks ago
Ontario, California, United States Young Douglas Farmers Insurance Full timeCustomer Service AssociateBecome a vital part of the team at Young Douglas Farmers Insurance as a Customer Service Associate. We are looking for a warm and committed individual who is eager to contribute positively to the experiences of our esteemed clients.BenefitsAttractive Hourly Compensation Based on ExperiencePathways for Professional...
-
Insurance Account Manager
7 days ago
Ontario, California, United States RRC Full timeAbout RRCRRC - Ruiz Recruiting & Consulting is a specialized recruitment firm dedicated to collaborating with startups and enterprise-level companies nationwide. Our mission is to facilitate growth by identifying and attracting exceptional talent.Job SummaryWe are seeking a highly skilled Commercial Lines Account Manager to join our team. As a key member of...
-
Insurance Agent Specialist
7 days ago
Ontario, California, United States HR Direct Full timeJob OverviewWe are seeking a dynamic Insurance Agent to join our team at HR Direct Services. The ideal candidate will be responsible for selling insurance policies to new and existing clients, providing exceptional customer service, and ensuring client satisfaction.Key Responsibilities:Communicate with clients to understand their insurance needs and...
-
Customer Service Specialist
2 weeks ago
Ontario, California, United States Young Douglas Farmers Insurance Full timeJob OverviewAre you passionate about providing exceptional service? Young Douglas Farmers Insurance is seeking a friendly and committed individual to fill the role of Receptionist/Customer Service Representative. This position is vital in ensuring our clients receive the support they need while interacting with our dedicated team.Compensation and...
-
Client Relations Specialist
1 week ago
Ontario, California, United States CTK USA, Inc. Full timeJob OverviewPosition SummaryCTK USA, INC. stands as a premier ally for e-commerce enterprises, delivering comprehensive logistics and fulfillment solutions across a variety of consumer product sectors. Our organization empowers merchants to concentrate on brand development and achieving substantial growth by offering innovative multi-channel order...
-
Medical Billing Specialist
3 weeks ago
Ontario, United States Marsell Wellness Center Full time $25 - $28Job DescriptionJob DescriptionJOB DESCRIPTION Job Title:Medical Billing SpecialistDepartment:Accounting Location:OntarioReports To:Accounting Manager FLSA Status:Hourly Remote Status:In OfficeSalary Range$25 to $28 hourPosition Summary: Reporting to the Accounting Manager and a member of the accounting team, this position is responsible for handling billing...
-
People Analytics Specialist
3 weeks ago
Ontario, United States Ajinomoto Foods North America Full timeOverview The HR Data Analytics Specialist will play a pivotal role in transforming HR operations through data-driven insights. This position is responsible for developing key performance indicators (KPIs), establishing data-driven HR approaches, and creating ROI measures. The specialist will collaborate with HR and other company leaders to align HR strategy...
-
Warranty Admin
4 weeks ago
Ontario, United States Rise Technical Recruitment Full timeWarranty Specialist Ontario, CA $20 p/h+ Bonus + 401(k) + Training + Benefits Package + Progression + Healthcare Package + PTO Are you a recent Graduate or Customer Service Rep starting your career, looking to work for a company that offers industry leading training, progression and growth opportunity within a dynamic warehouse environment? On offer is the...
-
Warranty Admin
2 months ago
Ontario, United States Rise Technical Recruitment Ltd Full timeWarranty SpecialistOntario, CA$20 p/h+ Bonus + 401(k) + Training + Benefits Package + Progression + Healthcare Package + PTOAre you a recent Graduate or Customer Service Rep starting your career, looking to work for a company that offers industry leading training, progression and growth opportunity within a dynamic warehouse environment? On offer is the...
-
Food Manufacturing- Payroll and Benefits Specialist
2 months ago
Ontario, United States Haliburton International Foods is hiring!! Full timeJob DescriptionJob DescriptionHaliburton International Foods, Inc. is seeking attention to detail, seasoned analytical, trustworthy Payroll/Benefits Specialist to join the HR team in Ontario, CA.This role will perform all payroll which includes intensive transfer functionality within the Paycom platform. In addition, manage the employee's timekeeping as...
-
Regulatory and Compliance Specialist
2 weeks ago
Ontario, United States Haliburton International Foods is hiring!! Full time $70,000 - $75,000Job DescriptionJob DescriptionSummaryThe Regulatory and Compliance Specialist must have solid knowledge of food regulation with emphasis on labeling, ingredient composition and claim substantiation. Responsible for all administrative tasks involving quality assurance and compliance with applicable FDA and USDA regulatory requirements. Essential Duties &...
-
Warehouse Returns Specialist
1 month ago
Ontario, United States New Vision International Full timeJob DescriptionJob DescriptionWe are looking for an organized individual to join our rapidly growing furniture company and work side by side with our warehouse crew. The RMA Clerk is expected to maintain, build, and create strong relationships with our customers. They should represent the company in a positive light by helping our team to the best of their...
-
Warehouse Returns Specialist
2 months ago
Ontario, United States NEW VISION INTERNATIONAL INC Full timeJob DescriptionJob DescriptionWe are looking for an organized individual to join our rapidly growing furniture company and work side by side with our warehouse crew. The RMA Clerk is expected to maintain, build, and create strong relationships with our customers. They should represent the company in a positive light by helping our team to the best of their...
-
Account Representative
3 months ago
Ontario, United States Michael Barraza - State Farm Agent Full timeJob DescriptionJob DescriptionROLE DESCRIPTION:Bilingual- Spanish RequiredMichael Barraza State Farm Agency is seeking an organized and efficient specialist to fulfill administrative duties and support insurance agents in gaining and keeping customers. As Account Associate with our agency, your attention to detail, dedication to client relations, and...
-
Marketing Representative
4 months ago
Ontario, United States Michael Barraza - State Farm Agent Full timeJob DescriptionJob DescriptionBenefits:Bonus based on performanceCompetitive salaryPaid time offROLE DESCRIPTION:Michael Barraza State Farm is seeking an organized and efficient specialist to fulfill administrative duties and support insurance agents in gaining and keeping customers. As a team member with our agency, your attention to detail, dedication to...