Claims Associate - Consumer

Sedgwick Claims Management Services; Florida; Hybrid; USD 42,000 - 62,000; Full time

Job summary

Sedgwick Claims Management Services is seeking a Claims Associate - Consumer in Florida to process first party property claims and determine benefits under client programs. You will handle high volumes of claims, make coverage determinations, and ensure timely payments and accurate documentation.

The role requires a high school diploma or GED, strong communication skills, and the ability to work in a team. Prior claims experience is preferred but not always required, with growth opportunities

Qualifications

• High school diploma or GED required.
• 1 year of general office experience; claims experience preferred.
• Knowledge of first party property and casualty claim adjudication is a plus.
• Strong oral and written communication skills; able to present information clearly.
• Ability to work well in a team and meet deadlines.

Responsibilities

• Process first party property claims and determine benefits per client programs.
• Make coverage determinations based on investigation and evaluation.
• Adjudicate proper settlements or denials within authority levels.
• Document claim files thoroughly; manage high volume of calls and correspondence.

Skills

Communication

Analytical skills

Team player

Problem solving

MS Office

Education

High school diploma or 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 - Consumer

PRIMARY PURPOSE

To process claims and determine benefits due pursuant to credit card or other financial program benefits plans; to make timely payments and adjustments for specified program claims; and to provide superior customer service.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Processes first party property claims based on basic coverage as defined by client-specific program.
• Makes coverage determinations based on investigation/evaluation.
• Adjudicates proper settlement or denials up to designated authority level.
• Handles high volume of claims, phone calls and correspondence ensuring claim files are properly documented; meets quality and production goals; and meets customer guidelines and deadlines.

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. Licenses as required or willingness/ability to move toward obtaining appropriate licensing as required.

Experience

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

Skills & Knowledge

• Knowledge of first party property and casualty claim adjudication as applicable to line of business
• Good oral and written communication, including presentation skills
• PC literate, including Microsoft Office products
• Analytical and interpretive skills
• Good organizational skills
• Good interpersonal skills
• Ability to work in a team environment
• 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, troubleshooting, problem solving, analysis, 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

NOTE:

Credit security clearance, confirmed via a background credit check, is required for this position.

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.

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.

Requisition #: R79327

tcv57hlu2