Claims Associate

About Sedgwick

• 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

Responsibilities

ESSENTIAL RESPONSIBILITIES MAY INCLUDE

• Adjusts medical-only claims and minor lost-time workers compensation claims under close supervision.
• Supports other claims representatives, examiners and leads with larger or more complex claims as necessary.
• Processes workers compensation claims determining compensability and benefits due; monitors reserve accuracy, and files necessary documentation with state agency.
• Communicates claim action/processing with claimant, client and appropriate medical contact.
• Ensures claim files are properly documented and claims coding is correct.
• May process routine payments and prescriptions and status reports for lifetime medical claims and/or defined period medical claims.
• Maintains professional client relationships.
• Performs other duties as assigned.
• Supports the organization's quality program(s).

Requirements

QUALIFICATION S Education & Licensing

• One (1) year of general office experience or equivalent combination of education and experience required.
• High school diploma or GED required.
• Licenses as required.
• Skills & Knowledge Excellent oral and written communication skills PC literate, including Microsoft Office products Analytical and interpretive skills Strong organizational skills Good interpersonal skills Ability to work in a team environment Ability to meet or exceed Performance Competencies

Preferred

• Claims industry experience preferred.

Work environment requirements

Work environment requirements include – Physical: Computer keyboarding Auditory/visual: Hearing, vision and talking Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines.

About this description

• 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.

Equal opportunity

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

A note on applying

• 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.