Claims Representative - Workers Compensation (Ontario, CA)

About the role

Sedgwick is hiring an on-site Claims Representative for Workers Compensation in Ontario, California. The role processes low-level workers compensation claims to determine benefits due, keeps claims adjudication within company standards and industry best practice, identifies subrogation and negotiates settlements under general supervision.

Key responsibilities

• Process low-level workers compensation claims, determining compensability and benefits due on long-term indemnity claims, monitor reserve accuracy and file the required documentation with the state agency.
• Develop and coordinate low-level claims action plans for resolution and return-to-work efforts, and approve claim payments.
• Approve and process assigned claims, determine benefits due and administer the action plan according to the claim or client contract.
• Perform other duties as assigned, support the organization's quality programs and travel as required.

Required profile

• Bachelor's degree from an accredited college or university preferred.
• Two years of claims management experience, or an equivalent combination of education and experience, or successful completion of Claims Representative training.
• Ability to think clearly, judge well, troubleshoot and solve problems, handle work-related stress and multiple priorities while meeting deadlines.

What we offer

• Starting pay of $26.55-$27 per hour for this role.
• Flexible work schedule, referral incentive program and career development opportunities.
• Medical, dental and vision coverage, 401K on day one, PTO, disability and life insurance, and other benefits.