Qureos Mentor

Sedgwick

Sedgwick is a leading provider of tech-enabled risk, benefits, and integrated business solutions, specializing in comprehensive claims management and loss adjusting across various industries. The company helps clients navigate unexpected challenges by offering services such as claims administration, workers' compensation, liability risk recovery, and benefits administration. Sedgwick aims to simplify complex processes and enhance client experiences through advanced technology and dedicated support.

<div>By joining Sedgwick, you'll be part of something truly meaningful. It&rsquo;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&rsquo;s no limit to what you can achieve.
Newsweek Recognizes Sedgwick as America&rsquo;s Greatest Workplaces National Top Companies
Certified as a Great Place to Work&reg;
Fortune Best Workplaces in Financial Services &amp; Insurance
Complex Claim Advisor - General Product and Liability | Multi-State Licensing Preferred - Hybrid
<div>Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world&rsquo;s best brands?
<ul><li>Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
</li><li>Leverage Sedgwick&rsquo;s broad, global network of experts to both learn from and to share your insights.
</li><li>Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.
</li><li>Enjoy flexibility and autonomy in your daily work, your location, and your career path.
</li><li>Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.
</li></ul>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:
 
Hybrid
PRIMARY PURPOSE OF THE ROLE : To develop targeted solutions and provide added technical guidance and oversight to ensure matters are resolved optimally while creating a culture of continual quality improvement designed to elevate the overall claim handling to benefit our stakeholders.
ESSENTIAL RESPONSIBILITIES MAY INCLUDE:
<ul><li>Proactively and strategically manages a complex claim inventory by assessing complex claims issues, utilizing jurisdictional expertise to provide oversight, and directs the handling to achieve the best possible resolution.
</li><li>Acts as the organizational subject matter expert for line of business and key jurisdictions on complex claim issues.
</li><li>Uses knowledge of all aspects of claims handling in evaluating exposure; recommends and directs action plans for issue or case resolution.
</li><li>Articulates and documents clear and concise file notes to allow stakeholders to understand the issues and path to resolution.
</li><li>Facilitates roundtables with groups/teams; engages appropriate internal and external resources as needed.
</li><li>Provides technical leadership on and maintains co-ownership of complex claim issues; through further influence creates a culture of continual quality improvement.
</li></ul>QUALIFICATIONS &amp; LICENSING
Education/Experience
Bachelor's degree from an accredited college or university preferred. Industry designation(s) preferred. Licenses as required for specific jurisdictions.
Experience
Ten (10) years of casualty claims experience or equivalent combination of education and experience required to include Five (5) + years of experience handling complex claims and experience in negotiation, mediation, arbitration or ADR skills on higher value complex claims. Supervisory experience a plus. Specific jurisdictional expertise preferred.
TAKING CARE OF YOU
<ul><li>Flexible work schedule.
</li><li>Referral incentive program.
</li><li>Career development and promotional growth opportunities.
</li><li>A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
</li></ul></div>Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
<h2 class="jobSectionHeader">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.</h2></div>

Complex Claim Advisor - General Product and Liability | Multi-State Licensing Preferred - Hybrid

<div>By joining Sedgwick, you'll be part of something truly meaningful. It&rsquo;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&rsquo;s no limit to what you can achieve.
Newsweek Recognizes Sedgwick as America&rsquo;s Greatest Workplaces National Top Companies
Certified as a Great Place to Work&reg;
Fortune Best Workplaces in Financial Services &amp; Insurance
Complex Claims Advisor | General Liability &amp; Auto Claims | License Required | NY Labor Law Knowledge Required
Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world&rsquo;s best brands?
<ul><li>Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.
</li><li>Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world&rsquo;s most respected organizations.
</li><li>Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
</li><li>Leverage Sedgwick&rsquo;s broad, global network of experts to both learn from and to share your insights.
</li><li>Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.
</li><li>Enjoy flexibility and autonomy in your daily work, your location, and your career path.
</li><li>Access diverse and comprehensive benefits to take care of your mental, physical, financial, and professional needs.
</li></ul>ARE YOU AN IDEAL CANDIDATE? To develop targeted solutions and provide added technical guidance and oversight to ensure matters are resolved optimally while creating a culture of continual quality improvement designed to elevate the overall claim handling to benefit our stakeholders.
PRIMARY PURPOSE OF THE ROLE: We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.
ESSENTIAL RESPONSIBLITIES MAY INCLUDE
<ul><li>Proactively and strategically manages a complex claim inventory by assessing complex claims issues, utilizing jurisdictional expertise to provide oversight, and directs the handling to achieve the best possible resolution.
</li><li>Acts as the organizational subject matter expert for line of business and key jurisdictions on complex claim issues.
</li><li>Uses knowledge of all aspects of claims handling in evaluating exposure; recommends and directs action plans for issue or case resolution.
</li><li>Articulates and documents clear and concise file notes to allow stakeholders to understand the issues and path to resolution.
</li><li>Facilitates roundtables with groups/teams; engages appropriate internal and external resources as needed.
</li><li>Provides technical leadership on and maintains co-ownership of complex claim issues; through further influence creates a culture of continual quality improvement.
</li></ul>QUALIFICATIONS
<ul><li>Education &amp; Licensing: 5 years of claims management experience or equivalent combination of education and experience required.
</li><li>AUTO &amp; GENERAL LIABILITY EXPERIENCE REQUIRED
</li><li>NY Labor Law knowledge and experience required
</li><li>Some leadership experience
</li><li>High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.
</li><li>Professional certification as applicable to line of business preferred.
</li></ul>Jurisdiction Knowledge: nationwide
Licensing: required
TAKING CARE OF YOU
Flexible work schedule.
Referral incentive program.
Career development and promotional growth opportunities.
A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
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 (80K - 105K). 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.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
<h2 class="jobSectionHeader">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.</h2></div>

Complex Claims Advisor | General Liability & Auto Claims | License Required | NY Labor Law Knowledge Required

<div>By joining Sedgwick, you'll be part of something truly meaningful. It&rsquo;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&rsquo;s no limit to what you can achieve.
Newsweek Recognizes Sedgwick as America&rsquo;s Greatest Workplaces National Top Companies
Certified as a Great Place to Work&reg;
Fortune Best Workplaces in Financial Services &amp; Insurance
Claims Examiner - Workers Compensation I Midwest Jurisdictions
<div>Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world&rsquo;s best brands?
<ul><li>Apply your workers compensation examiner knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.
</li><li>Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world&rsquo;s most respected organizations.
</li><li>Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
</li><li>Leverage Sedgwick&rsquo;s broad, global network of experts to both learn from and to share your insights.
</li><li>Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.
</li><li>Enjoy flexibility and autonomy in your daily work, your location, and your career path.
</li><li>Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.
</li></ul>PRIMARY PURPOSE OF THE ROLE: We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.
ARE YOU AN IDEAL CANDIDATE? To analyze workers compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
ESSENTIAL RESPONSIBLITIES MAY INCLUDE
<ul><li>Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
</li><li>Negotiating settlement of claims within designated authority.
</li><li>Communicating claim activity and processing with the claimant and the client.
</li><li>Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.
</li></ul>QUALIFICATIONS
Education &amp; Licensing: 5 years of claims management experience or equivalent combination of education and experience required.
<ul><li>High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.
</li><li>Professional certification as applicable to line of business preferred.
</li></ul>Licensing / Jurisdiction Knowledge: IL, MN, IN, WI
TAKING CARE OF YOU
<ul><li>Flexible work schedule.
</li><li>Referral incentive program.
</li><li>Opportunity to work in an agile environment.
</li><li>Career development and promotional growth opportunities.
</li><li>A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
</li></ul>Work environment requirements include &ndash;
 
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 $63,404 - $89,000/yr. 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. Always accepting applications.
</div>Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
<h2 class="jobSectionHeader">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.</h2></div>

Claims Examiner - Workers Compensation I Midwest Jurisdictions

<div>By joining Sedgwick, you'll be part of something truly meaningful. It&rsquo;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&rsquo;s no limit to what you can achieve.
Newsweek Recognizes Sedgwick as America&rsquo;s Greatest Workplaces National Top Companies
Certified as a Great Place to Work&reg;
Fortune Best Workplaces in Financial Services &amp; Insurance
Sr Disability Representative
Our teams connect! We collaborate onsite and have a hybrid work arrangement. All candidates must live near one of our centers of excellence:
Eden Prairie, MN : 11000 Prairie Lakes Drive Eden Prairie, MN 55344
PRIMARY PURPOSE : To provide disability case management and claim determinations based on complex medical documentation and the applicable disability plan interpretation including determining benefits due and making timely payments/approvals and adjustments, medically managing disability claims; coordinating investigative efforts, thoroughly reviewing contested claims, negotiating return to work with or without job accommodations, and evaluating and arranging appropriate referral of claims to outside vendors.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
<ul><li>Analyzes, approves and authorizes assigned claims and determines benefits due pursuant to a disability plan.
</li><li>Reviews and analyzes complex medical information (i.e. diagnostic tests, office notes, operative reports, etc.) to determine if the claimant is disabled as defined by the disability plan.
</li><li>Utilizes the appropriate clinical resources in case assessment (i.e. duration guidelines, in-house clinicians).
</li><li>Communicates with the claimants providers to set expectations regarding return to work.
</li><li>Determines benefits due, makes timely claims payments/approvals and adjustments for workers compensation, Social Security Disability Income (SSDI), and other disability offsets.
</li><li>Medically manages disability claims ensuring compliance with duration control guidelines and plan provisions.
</li><li>Communicates clearly with claimant and client on all aspects of claims process either by phone and/or written correspondence.
</li><li>Informs claimants of documentation required to process claims, required time frames, payment information and claims status either by phone, written correspondence and/or claims system.
</li><li>Coordinates investigative efforts ensuring appropriateness; provides thorough review of contested claims.
</li><li>Evaluates and arranges appropriate referral of claims to outside vendors or physician advisor reviews, surveillance, independent medical evaluation, functional capability evaluation, and/or related disability activities.
</li><li>Negotiates return to work with or without job accommodations via the claimants physician and employer.
</li><li>Refers cases as appropriate to team lead and clinical case management.
</li><li>Maintains professional client relationships.
</li></ul>ADDITIONAL FUNCTIONS and RESPONSIBILITIES
<ul><li>Performs other duties as assigned.
</li><li>Supports the organization's quality program(s).
</li></ul>QUALIFICATIONS
Education &amp; Licensing
 
Bachelor's degree from an accredited university or college preferred.
Experience
 
Three (3) years of benefits or disability case/claims management experience or equivalent combination of education and experience required.
Skills &amp; Knowledge
<ul><li>Knowledge of ERISA regulations, required offsets and deductions, disability duration and medical management practices and Social Security application procedures
</li><li>Working knowledge of medical terminology and duration management
</li><li>Excellent oral and written communication, including presentation skills
</li><li>PC literate, including Microsoft Office products
</li><li>Analytical and interpretive skills
</li><li>Strong organizational skills
</li><li>Ability to work in a team environment
</li><li>Excellent negotiation skills
</li><li>Ability to meet or exceed Performance Competencies
</li></ul>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
NOTE : Credit security clearance, confirmed via a background credit check, is required for this position.
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.
#claimsexaminer
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 $22.00-$24.00 hourly. 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.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
<h2 class="jobSectionHeader">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.</h2></div>

Sr Disability Representative

<div>By joining Sedgwick, you'll be part of something truly meaningful. It&rsquo;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&rsquo;s no limit to what you can achieve.
Newsweek Recognizes Sedgwick as America&rsquo;s Greatest Workplaces National Top Companies
Certified as a Great Place to Work&reg;
Fortune Best Workplaces in Financial Services &amp; Insurance
Workers' Compensation Claims Examiner | NY &amp; VT Jurisdictional Knowledge | Remote
Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world&rsquo;s best brands?
<ul><li>Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.
</li><li>Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world&rsquo;s most respected organizations.
</li><li>Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
</li><li>Leverage Sedgwick&rsquo;s broad, global network of experts to both learn from and to share your insights.
</li><li>Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.
</li><li>Enjoy flexibility and autonomy in your daily work, your location, and your career path.
</li><li>Access diverse and comprehensive benefits to take care of your mental, physical, financial, and professional needs.
</li></ul>ARE YOU AN IDEAL CANDIDATE? To analyze Medical Only &amp; Lost-Times Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
PRIMARY PURPOSE OF THE ROLE: We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.
ESSENTIAL RESPONSIBLITIES MAY INCLUDE
<ul><li>Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
</li><li>Negotiating settlement of claims within designated authority.
</li><li>Communicating claim activity and processing with the claimant and the client.
</li><li>Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.
</li></ul>QUALIFICATIONS
Education &amp; Licensing: 3 - 5 years of claims management experience or equivalent combination of education and experience required.
High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.
Professional certification as applicable to line of business preferred.
Jurisdiction Knowledge: NY, VT, &amp; ME (will train on other states)
Licensing: NY &amp; VT licensing preferred; not required
TAKING CARE OF YOU
Flexible work schedule.
Referral incentive program.
Career development and promotional growth opportunities.
A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
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 (70 - 80K). 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.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
<h2 class="jobSectionHeader">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.</h2></div>

Workers' Compensation Claims Examiner | NY & VT Jurisdictional Knowledge | Remote

<div>By joining Sedgwick, you'll be part of something truly meaningful. It&rsquo;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&rsquo;s no limit to what you can achieve.
Newsweek Recognizes Sedgwick as America&rsquo;s Greatest Workplaces National Top Companies
Certified as a Great Place to Work&reg;
Fortune Best Workplaces in Financial Services &amp; Insurance
Workers Compensation Claims Examiner | NY Jurisdiction &amp; Subrogation Experience &amp; NY Licensing Required
<div>Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world&rsquo;s best brands?
</div><ul><li>Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.
</li><li>Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world&rsquo;s most respected organizations.
</li><li>Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
</li><li>Leverage Sedgwick&rsquo;s broad, global network of experts to both learn from and to share your insights.
</li><li>Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.
</li><li>Enjoy flexibility and autonomy in your daily work, your location, and your career path.
</li><li>Access diverse and comprehensive benefits to take care of your mental, physical, financial, and professional needs.
</li></ul>ARE YOU AN IDEAL CANDIDATE? To analyze Lost-Time Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
Subrogation experience required.
PRIMARY PURPOSE OF THE ROLE: We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.
OFFICE LOCATION
Hybrid if within commutable distance to the Syracuse, NY office
Remote if outside of commutable distance
ESSENTIAL RESPONSIBLITIES MAY INCLUDE
<ul><li>Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
</li><li>Negotiating settlement of claims within designated authority.
</li><li>Communicating claim activity and processing with the claimant and the client.
</li><li>Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.
</li></ul>QUALIFICATIONS
Education &amp; Licensing: 5 years of claims management experience or equivalent combination of education and experience required.
High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.
Professional certification as applicable to line of business preferred.
Jurisdiction Knowledge: NY
Licensing: NY
TAKING CARE OF YOU
Flexible work schedule.
Referral incentive program.
Career development and promotional growth opportunities.
A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
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 (80 - 90K). 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.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
<h2 class="jobSectionHeader">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.</h2></div>

Workers Compensation Claims Examiner | NY Jurisdiction & Subrogation Experience & NY Licensing Required

<div>By joining Sedgwick, you'll be part of something truly meaningful. It&rsquo;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&rsquo;s no limit to what you can achieve.
Newsweek Recognizes Sedgwick as America&rsquo;s Greatest Workplaces National Top Companies
Certified as a Great Place to Work&reg;
Fortune Best Workplaces in Financial Services &amp; Insurance
Workers Compensation Claims Associate | Rancho Cordova, CA
Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career?
<ul><li>A stable and consistent work environment in an office and/or virtual setting
</li><li>Career development and promotional growth opportunities through increasing responsibilities
</li><li>A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs
</li></ul>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
 
Rancho Cordova, California (On-site)
PRIMARY PURPOSE OF THE ROLE: Analyze reported lower-level workers compensation claims to determine benefits eligibility and ensure ongoing adjudication aligns with company standards and industry best practices.
ESSENTIAL RESPONSIBLITIES MAY INCLUDE
<ul><li>Handles medical-only and minor lost-time workers compensation claims under supervision.
</li><li>Assists senior claims staff with complex cases as needed.
</li><li>Determines compensability and benefits; ensures reserve accuracy and files required documentation.
</li><li>Communicates claim status with claimants, clients, and medical contacts.
</li><li>Maintains accurate documentation and correct claims coding.
</li><li>Processes routine payments, prescriptions, and status reports for ongoing medical claims.
</li><li>Builds and maintains professional client relationships.
</li></ul>QUALIFICATIONS
Education &amp; Licensing: 1 year of general office experience or equivalent combination of education and experience required. Claims industry experience preferred.
<ul><li>High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.
</li><li>Professional certification as applicable to line of business preferred.
</li></ul>TAKING CARE OF YOU
<ul><li>Flexible work schedule.
</li><li>Referral incentive program.
</li><li>Career development and promotional growth opportunities.
</li><li>A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
</li></ul>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 $20.00-$22.00/hr. 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.
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&rsquo; 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.
<h2 class="jobSectionHeader">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.</h2></div>

Workers Compensation Claims Associate | Rancho Cordova, CA

Join Sedgwick and explore 31   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.