Claims Associate

Sedgwick; Bartlesville (OK); On-site; USD 40,000 - 54,000; Full time

Job summary

Sedgwick is seeking a Claims Associate to analyze lower-level workers’ compensation claims and determine benefits due, while ensuring timely adjudication in line with company standards.

You will support fellow claims professionals on larger cases, maintain accurate documentation and coding, communicate with claimants and clients, and contribute to Sedgwick's quality programs in a collaborative, team-oriented environment.

Qualifications

• One year of general office experience or equivalent combination of education and experience required.
• Claims industry experience preferred.

Responsibilities

• Adjusts workers’ compensation claims under close supervision.
• Supports other claims representatives on larger/more complex claims.
• Processes claims determining compensability and benefits due; files documentation.
• Communicates claim actions with claimants, clients and medical contacts.
• Ensures claim files are properly documented and claims coding is correct.
• May process routine payments and status reports for certain claims.
• Maintains professional client relationships.
• Supports the organization’s quality program(s).

Skills

Communication

Teamwork

Organization

Interpersonal skills

Education

High School Diploma / GED

Tools

Microsoft Office

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

Claims Associate

PRIMARY PURPOSE OF THE ROLE

To analyze reported lower-level workers compensation claims to determine benefits due; and to ensure ongoing adjudication of claims within company standards and industry best practices.

ESSENTIAL RESPONSIBILITIES

• 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).

QUALIFICATION S

Education & Licensing: One (1) year of general office experience or equivalent combination of education and experience required. Claims industry experience preferred. 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

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.

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.

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.