Sedgwick LLP jobs in Riverside, CA - 54 jobs

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 Examiner | Dedicated Account | Long Beach, CA (3 Days 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'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 Long Beach, CA (Hybrid - 2 days in office, 3 days remote) PRIMARY PURPOSE OF THE ROLE: 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 * 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. * Negotiating settlement of claims within designated authority. * Communicating claim activity and processing with the claimant and the client. * Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner. QUALIFICATIONS Education & 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. Licensing / Jurisdiction Knowledge: California workers' compensation claims handling experience required | SIP 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. 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 $80,000-$98,000/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. #claimsexaminer #claims #hybrid #LI-DA1 #LI-Hybrid 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.

Mindlance is a national recruiting company which partners with many of the leading employers across the country. Feel free to check us out at ************************ open for CareMore Sales Extender located in Upland, CA with a competitive hourly rate. After reviewing your resume posted on an online job board, I believe your education and skill set could be a good fit for this particular opportunity. Please review the highlights of the position below and if this is of interest to you, please call me directly at ************ to discuss the particulars. If this role is not of interest to you, please respond with a short overview of the types of opportunities that you feel best reflect your education, experience and career path. Job Description Job Title : CareMore Sales Extender Client Location : 141 W Foothill Boulevard, Upland CA 91786 Contract Duration : 12+ Months contract (possibility of extension based on performance) Work Timings : M-F 40 hours per week - Must have flexible schedule due to evening and weekend work. Pay rate : $ 18.56/hr Responsible for collaborating with Sales and Business Development Teams to generate leads from community events, expos, and sales camps held at a variety of locations including pharmacies, provider offices, senior centers, food banks, discount stores and other retail locations. MAJOR JOB DUTIES AND RESPONSIBILITIES: Primary duties may include, but are not limited to: Represents CareMore at community/company-sponsored events. Facilitates onsite enrollments at events and assists at sales meetings. Maintains knowledge of provider network, product portfolio, and associated eligibility guidelines for various election periods. Develops good working relationships with internal constituents. Qualifications EDUCATION/EXPERIENCE : Requires a high school diploma; related sales experience; or any combination of education and experience, which would provide an equivalent background. AA or BA/BS preferred. Current Life and Disability agent license preferred. Medicare Advantage Products experience preferred. Bilingual (English/Spanish) preferred. Additional Information Looking for Bilingual (English/Spanish) candidates who have experience in Sales background & administration with Current Life and Disability agent license. If you are interested feel free to reach Priti Kumari at ************ or send me the updated resume on pritik@mindlance(dot)com

Job Title: Web Content Producer Duration: 5 Months Job Description: Content publishing, basic HTML coding, Microsoft Expression, Word, Excel, and SEO experience is preferred. The ideal candidate will have a strong writing and editing background and be familiar with our content publishing guidelines. • Must be proficient HTML editing tool (Microsoft Expression or equivalent), Good HTML coding skills • Familiar with CMS (content management systems) • Understand SEO • Must have excellent spelling and grammar skills, as well as a firm grasp of the English language • Experience in lay editing • Word, and Excel, basic Photoshop skills (preferred, not required) • Social media experience (Facebook, Twitter, etc.) Desired (not required) Skills: • Experience in working in a similar health-related environment Education/Certifications: • 3-5 years of experience in related field • BA degree or related field Additional Information Thanks & Regards' ___________________________________________________________________________ Vikram Bhalla | Team Recruitment | Mindlance, Inc. | W: ************

Business Health Program Rep I Division Healthcare Contract 5 Months Work Schedule 8AM - 5PM with 1 hr. lunch. There will be optional overtime during week and on Saturdays as needed. Qualifications Essential Functions · Responsible for providing initial contact between distinct Care Management programs and specific identified members. · Under direct supervision handles inbound/outbound enrollment and engagement calls with eligible members to provide information regarding program features. · Primary duties may include, but are not limited to: Gathers and records appropriate member information in accordance with policies and procedures via telephone. · Encourages members to participate in the Care Management programs by providing information about the program, outlining program features/value and explaining available services. · Records call details and utilize call scripts as needed based on client requirements. · Directs member inquiries to appropriate clinical staff. Initiates referrals and manages consults from clinicians for participants registered in Care Management. · Gathers information from hospitals, health plans, physicians, patients, vendors and other referral sources. · Contacts physician offices to obtain demographic information or related data as needed. · Requires HS diploma or the equivalent; 6 months experience in a telesales or customer service demonstrating ability to influence customers/ members; or any combination of education and experience, which would provide an equivalent background. · Computer/keyboarding proficiency and the ability to follow defined policies and protocols required. Knowledge of company products, services and benefits preferred. If you are available and interested then please reply me with your “ Chronological Resume” and call me on ************** . Additional Information Thanks & Regards, Ranadheer Murari | Team Recruitment | Mindlance, Inc. | W : ************ *************************

Job Title : Cust Care Rep II Contract Duration : 4+ Months Extendable Contract Work Timings : Monday - Friday 9:00am to 8:00pm (any 8-9 hours) SUMMARY: Responds to customer questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility and claims. Proficient in all basic customer service areas, performs some but not all types of moderately complex function Major Job Duties And Responsibilities: Primary duties may include, but are not limited to: Analyzes problems and provides information/solutions. Operates a PC/image station to obtain and extract information; documents information, activities and changes in the database. Thoroughly documents inquiry outcomes for accurate tracking and analysis. Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner. Researches and analyzes data to address operational challenges and customer service issues. Provides external and internal customers with requested information. Proficient in all basic customer service functions. Receives and places follow-up telephone calls / e-mails to answer customer questions. Inquiries may also be on a walk-in basis. May require deviation from standard practices and procedures with the assistance of a computerized system. Requires general knowledge of company services, products, insurance benefits, provider contracts and claims. Seeks, understands and responds to the needs and expectations of internal and external customers. Qualifications Education/Experience: Requires a High school diploma or equivalent (GED); 6-24 months experience in automated customer service environment, preferably in healthcare or insurance sector or any combination of education and experience, which would provide an equivalent background. Additional Information I appreciate your prompt response. Thanks & Regards, _________________________________________________________________________________ Sahiba Sharma +1 732 - 243 - 0288

blood collection by venipuncture and capillary technique from patients of all age groups, urine drug screen collections, paternity collections, breath/saliva alcohol testing, LCM/Cyber Tools, TestCup, pediatric blood collections, difficult draws Additional Information Pushkaraj Hachibatti | Mindlance, Inc. | Office- ************

Responsible for collaborating with Sales and Business Development Teams to generate leads from community events, expos, and sales camps held at a variety of locations including pharmacies, provider offices, senior centers, food banks, discount stores and other retail locations. • Major Job Duties And Responsibilities: • Primary duties may include, but are not limited to Represents CareMore at community/company-sponsored events • Facilitates onsite enrollments at events and assists at sales meetings • Maintains knowledge of provider network, product portfolio, and associated eligibility guidelines for various election periods • Develops good working relationships with internal constituents Qualifications Education/experience • Requires a high school diploma; related sales experience; or any combination of education and experience, which would provide an equivalent background • AA or BA/BS preferred. • Medicare Advantage Products experience preferred. Bilingual (English/Spanish) preferred Additional Information Sanoj vk | Team Recruitment | Mindlance, Inc. | W: ************

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 Leave of Absence Coordinator Leave of Absence Coordinator Our teams thrive together! We collaborate in person and embrace a flexible hybrid work style. To join us, you'll need to live near one of our dynamic Centers of Excellence West Hills, CA. 8521 Fallbrook Ave. Suite 250, West Hills, CA What we offer: * A stable, consistent work environment-both in-office and virtual * A comprehensive training program to help you support employees and customers from some of the world's most respected brands * A dedicated mentor and manager to guide you every step of your career journey * Career development and promotional opportunities as you take on new responsibilities * A diverse, all-inclusive benefits package designed to support your mental, physical, financial, and professional well-being Your next big opportunity starts here-are you ready to join us? PRIMARY PURPOSE OF THE ROLE: To analyze reported leave requests and determine paid leave benefits due based on client paid leave plans, policies, state and federal regulations and to make timely calculations, payments and/or adjustments for client paid leave plans ensuring that on-going claim management is within company service standards and industry best practices. ARE YOU AN IDEAL CANDIDATE? We are looking for enthusiastic and empathetic candidates that want to grow a career. Ideal candidates will thrive in a collaborative team environment, show motivation, and drive in their work ethic, are customer-oriented, naturally empathic and solution-focused. ESSENTIAL RESPONSIBLITIES MAY INCLUDE * Establishes FMLA claims; tracks and codes documentation in accordance with internal workflow processes. * Analyzes FMLA and other paid leave claims to determine eligibility, certification, payment calculations, payments and/or adjustments in compliance with client paid leave plans, policies, and state and federal regulations. * Identifies action plan, determines benefits due, and makes timely case decisions based on service expectations as established by the client. * Communicates decisions and on-going expectations with claimants and clients. * Maintains professional client relationships. * Attendance during scheduled work hours is required. QUALIFICATIONS * Education & Licensing: High school diploma or GED required. * Skills: Strong oral and written communication, computer literate - including Microsoft Office, organizational skills required * PC literate, including Microsoft Office products, Windows environment. * Must meet minimum typing requirements. * Experience: Clerical or customer service experience or equivalent combination of education and experience preferred TAKING CARE OF YOU * Entry-level colleagues are offered a world class training program with a comprehensive curriculum * An assigned mentor and manager that will support and guide you on your career journey * Career development and promotional growth opportunities * A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more WORK ENVIRONMENT When applicable and appropriate, consideration will be given to reasonable accommodations. Mental: Clear and conceptual thinking ability; excellent judgment and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines Physical: Ability to sit at a desk for extended periods while operating a computer and phone system. Travel as required. Auditory/Visual: Hearing, vision and talking 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 (18.00 - 23.00). 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' 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.

Mindlance is a national recruiting company which partners with many of the leading employers across the country. Feel free to check us out at ************************* Job Description Exhibit proficiency in all of the following: blood collection by venipuncture and capillary technique from patients of all age groups, urine drug screen collections, paternity collections, breath/saliva alcohol testing, LCM/Cyber Tools, TestCup, pediatric blood collections, difficult draws Additional Information Please call me @ ************ to discuss details of this job .

Perform front desk activities, such as unlocking doors, starting computer, and answering the phone. Greet patient and enter patient health insurance information and collect current or past due payment amount(s). Call physician offices to confirm test orders and file records according to policy. Additional Information For any queries please call me @ ************.

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 Office Assistant | Pasadena, CA (In-Office) Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career? A stable and consistent work environment in an office setting A training program to learn how to help employees and customers from some of the world's most reputable brands An assigned mentor and manager who will guide you on your career journey Career development and promotional growth opportunities through increasing responsibilities A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs PRIMARY PURPOSE OF THE ROLE: To support office administration functions. 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 Pasadena, CA ESSENTIAL RESPONSIBLITIES MAY INCLUDE Types form letters. Sets up, maintains and locates claim files. Processes packets. Conducts computer data entry and processing; documents claim files in the system correctly. Prepares spreadsheets and documents in software applications. Answers and initiates telephone calls as required. Maintains stationary supplies. Sends overnight and messenger outgoing mail. Processes returned letters and unidentified mail. Transmits facsimiles. Prints reports and documents QUALIFICATIONS Education & Licensing: High school diploma or GED required Skills: Strong oral and written communication, computer literate - including Microsoft Office, organizational skills required Experience: Clerical or customer service experience or equivalent combination of education and experience preferred TAKING CARE OF YOU Entry-level colleagues are offered a world class training program with a comprehensive curriculum An assigned mentor and manager that will support and guide you on your career journey Career development and promotional growth opportunities A diverse and comprehensive benefits offering including medical, dental vision, 401K, PTO and more 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 $17.50 - $19.50 per hour . 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' 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.

Mindlance is a national recruiting company which partners with many of the leading employers across the country. Feel free to check us out at ************************ One of our clients has a temporary position open for CareMore Sales Extender located in Upland, CA with a competitive hourly rate. After reviewing your resume posted on an online job board, I believe your education and skill set could be a good fit for this particular opportunity. Please review the highlights of the position below and if this is of interest to you, please call me directly at ************ to discuss the particulars. If this role is not of interest to you, please respond with a short overview of the types of opportunities that you feel best reflect your education, experience and career path. Job Description Job Title : CareMore Sales Extender Client Location : 141 W Foothill Boulevard, Upland CA 91786 Contract Duration : 12+ Months contract (possibility of extension based on performance) Work Timings : M-F 40 hours per week - Must have flexible schedule due to evening and weekend work. Pay rate : $ 18.56/hr Responsible for collaborating with Sales and Business Development Teams to generate leads from community events, expos, and sales camps held at a variety of locations including pharmacies, provider offices, senior centers, food banks, discount stores and other retail locations. MAJOR JOB DUTIES AND RESPONSIBILITIES: Primary duties may include, but are not limited to: Represents CareMore at community/company-sponsored events. Facilitates onsite enrollments at events and assists at sales meetings. Maintains knowledge of provider network, product portfolio, and associated eligibility guidelines for various election periods. Develops good working relationships with internal constituents. Qualifications EDUCATION/EXPERIENCE: Requires a high school diploma; related sales experience; or any combination of education and experience, which would provide an equivalent background. AA or BA/BS preferred. Current Life and Disability agent license preferred. Medicare Advantage Products experience preferred. Bilingual (English/Spanish) preferred. Additional Information Looking for Bilingual (English/Spanish) candidates who have experience in Sales background & administration with Current Life and Disability agent license. If you are interested feel free to reach Priti Kumari at ************ or send me the updated resume on pritik@mindlance(dot)com

Mindlance is a national recruiting company which partners with many of the leading employers across the country. Feel free to check us out at ************************* Job Title: Web Content Producer Location: San Clemente, CA Duration: 5 Months Job Description: Content publishing, basic HTML coding, Microsoft Expression, Word, Excel, and SEO experience is preferred. The ideal candidate will have a strong writing and editing background and be familiar with our content publishing guidelines. • Must be proficient HTML editing tool (Microsoft Expression or equivalent), Good HTML coding skills • Familiar with CMS (content management systems) • Understand SEO • Must have excellent spelling and grammar skills, as well as a firm grasp of the English language • Experience in lay editing • Word, and Excel, basic Photoshop skills (preferred, not required) • Social media experience (Facebook, Twitter, etc.) Desired (not required) Skills: • Experience in working in a similar health-related environment Education/Certifications: • 3-5 years of experience in related field • BA degree or related field Additional Information Thanks & Regards' ___________________________________________________________________________ Vikram Bhalla | Team Recruitment | Mindlance, Inc. | W: ************

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 General Liability Claims Examiner 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. PRIMARY PURPOSE: To analyze complex or technically difficult general liability and auto liability claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements. ESSENTIAL FUNCTIONS and RESPONSIBILITIES * Analyzes and processes complex or technically difficult general liability and auto liability claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution. * Assesses liability and resolves claims within evaluation. * Negotiates settlement of claims within designated authority. * Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim. * Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level. * Prepares necessary state fillings within statutory limits. * Manages the litigation process; ensures timely and cost effective claims resolution. * Coordinates vendor referrals for additional investigation and/or litigation management. * Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients. * Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets. * Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner. * Communicates claim activity and processing with the claimant and the client; maintains professional client relationships. * Ensures claim files are properly documented and claims coding is correct. * Refers cases as appropriate to supervisor and management. QUALIFICATION Education & Licensing Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. Experience Five (5) years of General Liability claims management experience or equivalent combination of education and experience required. TAKING CARE OF YOU * 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 $75,000 - $90,000. 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. #Claims #ClaimsExaminer #Hybrid #LI-Hybrid #LI-Remote #LI-AM1 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.

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 Disability Representative Sr Our teams connect! We collaborate onsite and have a hybrid work arrangement. All candidates must live near one of our centers of excellence: Dubuque, IA : 4141 Westmark Drive, Dubuque, IA 52002 Cedar Rapids, IA : 333 1st Street SE Ste. 200 Cedar Rapids IA 52401 Coralville, IA: 3273 Ridgeway Drive Coralville IA 52241 Dublin, OH : 5500 Glendon Court Dublin OH 43016 New Albany, OH : 7795 Walton Parkway New Albany, OH 43054 Chicago, IL : 175 W. Jackson Blvd. 12th Fl. Chicago IL 60604 Indianapolis, IN: 8909 Purdue Road Suite 501 Indianapolis, IN 46268 Irving, TX: 2201 W. Royal Lane Suite 125 Irving, TX 75063 Memphis, TN : 8125 Sedgwick Way, Memphis TN 38125 Southfield, MI : 300 Galleria Officentre Southfield MI 48034 Orlando, FL : 12650 Ingenuity Dr Orlando FL 32826 Eden Prairie, MN : 11000 Prairie Lakes Drive Eden Prairie, MN 55344 West Hills, CA : 8521 Fallbrook Ave West Hills, CA 91304 PRIMARY PURPOSE: Provides disability case management and complex claim determinations based on medical documentation and the applicable disability plan interpretation including determining benefits due and making timely payments/approvals and adjustments, medically managing disability claims including comorbidities, concurrent plans, and complex ADA accommodations; coordinates investigative efforts, thoroughly reviews contested claims, negotiates return to work with or without job accommodations, and evaluates and arranges appropriate referral of claims to outside vendors. ESSENTIAL FUNCTIONS and RESPONSIBILITIES * Makes independent claim determinations, based on the information received, to approve complex disability claims or makes a recommendation to team lead to deny claims based on the disability plan. * Reviews and analyzes complex medical information (i.e. attending physician statements, office notes, operative reports, etc.) to determine if the claimant is disabled as defined by the disability plan. * Oversees additional facets of complex claims including but not limited to comorbidities, concurrent plans, complex ADA accommodations, and claims outside of typical guidelines. * Utilizes the appropriate clinical resources in case assessment (i.e. duration guidelines, in-house clinicians), as needed. * Determines benefits due pursuant to a disability plan, makes timely claims payments/approvals and adjustments for workers compensation, Social Security Disability Income (SSDI), and other disability offsets. * Informs claimants of documentation required to process claims, required time frames, payment information and claims status by phone, written correspondence and/or claims system. * Communicates with the claimants' providers to set expectations regarding return to work. * Medically manages complex disability claims ensuring compliance with duration control guidelines and plan provisions. * Communicates clearly and timely with claimant and client on all aspects of claims process by phone, written correspondence and/or claims system. * Coordinates investigative efforts ensuring appropriateness; provides thorough review of contested claims. * 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. * Negotiates return to work with or without job accommodations via the claimant's physician and employer. * Refers cases to team lead and clinical case management for additional review when appropriate. * Maintains professional client relationships and provides excellent customer service. * Meets the organization's quality program(s) minimum requirements. ADDITIONAL FUNCTIONS and RESPONSIBILITIES * Performs other duties as assigned. QUALIFICATIONS Education & Licensing High School diploma or GED required. Bachelor's degree from an accredited university or college preferred. State certification or licensing in statutory leaves is preferred or may be required based on state regulations. Experience Three (3) years of benefits or disability case/claims management experience or equivalent combination of education and experience preferred. Skills & Knowledge * Knowledge of ERISA regulations, required offsets and deductions, disability duration and medical management practices and Social Security application procedures * Knowledge of state and federal FMLA regulations * Working knowledge of medical terminology and duration management * Excellent oral and written communication, including presentation skills * Proficient computer skills including working knowledge of Microsoft Office * Analytical, interpretive, and critical thinking skills * Ability to manage ambiguity * Strong organizational and multitasking skills * Ability to work in a team environment * Ability to meet or exceed performance competencies as required by program * Effective decision-making and negotiation skills * Ability to exercise judgement autonomously within established procedures 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: Ability to sit at a desk for extended periods while operating a computer and phone system. Travel as required. Auditory/Visual: Hearing, vision and talking 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 $22.00 - $25.00 USD 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. 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.

Mindlance is a national recruiting company which partners with many of the leading employers across the country. Feel free to check us out at ************************* Job Description Business Health Program Rep I Location 12900 Park Plaza Drive, Cerritos CA 90703, USA Division Healthcare Contract 5 Months Work Schedule 8AM - 5PM with 1 hr. lunch. There will be optional overtime during week and on Saturdays as needed. Qualifications Essential Functions · Responsible for providing initial contact between distinct Care Management programs and specific identified members. · Under direct supervision handles inbound/outbound enrollment and engagement calls with eligible members to provide information regarding program features. · Primary duties may include, but are not limited to: Gathers and records appropriate member information in accordance with policies and procedures via telephone. · Encourages members to participate in the Care Management programs by providing information about the program, outlining program features/value and explaining available services. · Records call details and utilize call scripts as needed based on client requirements. · Directs member inquiries to appropriate clinical staff. Initiates referrals and manages consults from clinicians for participants registered in Care Management. · Gathers information from hospitals, health plans, physicians, patients, vendors and other referral sources. · Contacts physician offices to obtain demographic information or related data as needed. · Requires HS diploma or the equivalent; 6 months experience in a telesales or customer service demonstrating ability to influence customers/ members; or any combination of education and experience, which would provide an equivalent background. · Computer/keyboarding proficiency and the ability to follow defined policies and protocols required. Knowledge of company products, services and benefits preferred. If you are available and interested then please reply me with your “Chronological Resume” and call me on **************. Additional Information Thanks & Regards, Ranadheer Murari | Team Recruitment | Mindlance, Inc. | W: ************ *************************

blood collection by venipuncture and capillary technique from patients of all age groups, Additional Information If you or any one from your network is looking for a change and interested to know more about this role; do call me on ************

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 Service Center Representative- Blue Ash| Cincinnati, OH (In-Office ) 12pm -8pm or 3pm-11pm shift with rotating Saturdays 10am-6pm (Open) Service Center Representative Our teams thrive together! We collaborate onsite 5 days a week. All candidates must live near our center of excellence: Our Blue Ash Office: 4445 Lake Forest Drive Suites 400 and 275 Blue Ash, OH 45242-3739 (This position is only available in this office) WORK SCHEDULE Monday-Friday: 12:00pm to 8:00pm Monday-Friday 3:00pm to 11:00pm Rotating Saturdays: 10:00am to 6:00pm What we offer: * A stable, consistent work environment-both in-office and virtual * A comprehensive training program to help you support employees and customers from some of the world's most respected brands * A dedicated mentor and manager to guide you every step of your career journey * Career development and promotional opportunities as you take on new responsibilities * A diverse, all-inclusive benefits package designed to support your mental, physical, financial, and professional well-being Your next big opportunity starts here-are you ready to join us? PRIMARY PURPOSE: To provide excellent service to callers regarding claims for multiple lines of business; to expedite the claims application process and provide detailed claim notes on all calls; to resolve issues with one call/one person response; and to direct calls to appropriate escalation path as needed. ESSENTIAL FUNCTIONS and RESPONSIBILITIES * Acts as primary liaison with callers; follows client specifications in assisting with questions and solving problems related to the claims application and servicing processes. * Educates and informs the customer via multiple communication channels about documentation required to process a claim, required time frames, payment information, and claim status. * Educates claimants/callers on client requirements and benefit plans documenting all required details of the call in a concise professional manner. * Enters verbal and written application information that meets both the internal and external customer's requirements accurately into the claims management system. * Assigns new claims to the appropriate claims handler. * Directs customer calls to the appropriate contact at multiple locations or escalates to Service Center Specialist/management as needed. * Attendance during scheduled work hours is required. ADDITIONAL FUNCTIONS and RESPONSIBILITIES * Performs other duties as assigned. * Supports the organization's quality program(s). QUALIFICATIONS Education & Licensing High school diploma or GED required. College courses preferred Experience One (1) year customer service experience or equivalent combination of education and experience required. Inbound call center experience preferred. Skills & Knowledge * Knowledge of medical terminology * Understanding of claims management * Excellent oral and written communication skills * PC literate, including Microsoft Office products * Strong organizational skills * Good interpersonal skills * Ability to multi task in fast paced environment * Ability to support multiple clients across communication channels and utilize multiple systems simultaneously * Ability to work in a team environment and/or independently * Ability to meet or exceed Performance Competencies * WORK ENVIRONMENT When applicable and appropriate, consideration will be given to reasonable accommodations. Mental: Clear and conceptual thinking ability; excellent judgment 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 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 (17.47 - 18.75). 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. 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.

Mindlance is a national recruiting company which partners with many of the leading employers across the country. Feel free to check us out at ************************ open for CareMore Sales Extender located in Victorville, CA with a competitive hourly rate. After reviewing your resume posted on an online job board, I believe your education and skill set could be a good fit for this particular opportunity. Please review the highlights of the position below and if this is of interest to you, please call me directly at ************ to discuss the particulars. If this role is not of interest to you, please respond with a short overview of the types of opportunities that you feel best reflect your education, experience and career path. Job Description Job Title : CareMore Sales Extender Client Location : 12441 Hesperia Rd. Suite A5 and A6, Victorville CA 92395 Contract Duration : 12+ Months contract (possibility of extension based on performance) Work Timings : M-F 40 hours per week - Must have flexible schedule due to evening and weekend work. Pay rate : $17.76/hr Responsible for collaborating with Sales and Business Development Teams to generate leads from community events, expos, and sales camps held at a variety of locations including pharmacies, provider offices, senior centers, food banks, discount stores and other retail locations. MAJOR JOB DUTIES AND RESPONSIBILITIES: Primary duties may include, but are not limited to: Represents CareMore at community/company-sponsored events. Facilitates onsite enrollments at events and assists at sales meetings. Maintains knowledge of provider network, product portfolio, and associated eligibility guidelines for various election periods. Develops good working relationships with internal constituents. Qualifications EDUCATION/EXPERIENCE : Requires a high school diploma; related sales experience; or any combination of education and experience, which would provide an equivalent background. AA or BA/BS preferred. Current Life and Disability agent license preferred. Medicare Advantage Products experience preferred. Bilingual (English/Spanish) preferred. Additional Information Looking for Bilingual (English/Spanish) candidates who have experience in Sales background & administration with Current Life and Disability agent license. If you are interested feel free to reach Priti Kumari at ************ or send me the updated resume on pritik@mindlance(dot)com