Workers Compensation Claims Adjuster | Rancho Cucamonga, CA

Workers Compensation Claims Adjuster | Rancho Cucamonga, CA Rancho Cucamonga, CA Job Details Full-time 18 hours ago Benefits Health savings account Disability insurance Health insurance Dental insurance 401(k) Paid time off Vision insurance 401(k) matching Flexible schedule Life insurance Referral program Qualifications Medical claims processing Utilization review Medical coding Subrogation Mid-level High school diploma or GED Bachelor's degree Workers' compensation claims Settlement negotiation Claims documentation management 4 years Full Job Description 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 Workers Compensation Claims Adjuster | Rancho Cucamonga, CA 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's best brands? Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world's most respected organizations. Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. Leverage Sedgwick's broad, global network of experts to both learn from and to share your insights. Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career. Enjoy flexibility and autonomy in your daily work, your location, and your career path. Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

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 Cucamonga, CA - Hybrid

PRIMARY PURPOSE OF THE ROLE

To analyze mid- and higher-level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements.

ESSENTIAL RESPONSIBLITIES MAY INCLUDE

Manages workers' compensation claims, including determining compensability and benefits, developing action plans, monitoring reserve accuracy, and ensuring timely resolution in accordance with claim or client contracts. Processes and approves claim payments, coordinates return-to-work efforts, manages subrogation, and negotiates settlements. Communicates claim activity with claimants and clients while maintaining strong professional relationships. Ensures accurate claim documentation, coding, and required state and physician filings. May handle complex lifetime or defined-period medical claims, including utilization review treatment decisions.

QUALIFICATIONS

Education & Licensing:

4 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. Licensing /

Jurisdiction Knowledge:

California workers' compensation claims handling experience | SIP certified preferred

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 $70,000-$80,000/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. #claimsadjuster #claims #remote #LI-GC1 #LI-Remote 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' 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. 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.