Claims Representative – Workers Compensation

Sedgwick

Claims Representative processing low level workers compensation claims at Sedgwick. Engaging with clients to determine compensability and benefits while coordinating resolution plans.

Posted 7/24/2026full-timeRiverside • California • 🇺🇸 United StatesJuniorMid-Level💰 $28 - $30 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing low level workers compensation claims, including determining compensability, benefits administration, and coordinating action plans for resolution and return-to-work efforts. Proficient in claims processing and documentation filing with state agencies.

Highest-signal resume keywords

Claims Management ExperienceWorkers Compensation Claims ProcessingBenefits AdministrationAction Plan DevelopmentBachelor's Degree

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ProcessingCompensability DeterminationBenefits CalculationDocumentation FilingReserve Monitoring

Industry Keywords

Workers CompensationIndemnity ClaimsReturn-to-Work EffortsClaims Representative Training

About the role

Key responsibilities & impact

Process low level workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.
Develops and coordinates low level workers compensation claims' action plans to resolution, return-to-work efforts, and approves claim payments.
Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract.

Requirements

What you’ll need

Bachelor's degree from an accredited college or university preferred.
Two (2) years of claims management experience or equivalent combination of education and experience or successful completion of Claims Representative training required.

Benefits

Comp & perks

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.