Claims Associate - Consumer

Sedgwick; Florida; On-site; USD 36,000 - 48,000; Full time

Job summary

Sedgwick Claims Management Services Ltd is seeking a Claims Associate - Consumer to process first party property claims, determine coverage, and ensure timely payments. The role emphasizes accurate adjudication, customer service, and strong documentation of all claim activity.

The ideal candidate will have a high school diploma or GED and at least one year of general office experience, with claims knowledge preferred.

Qualifications

• High school diploma or GED required.
• 1 year of general office experience; claims industry experience preferred.
• Licenses as required or willingness to obtain licensing.

Responsibilities

• Process first party property claims based on basic coverage.
• Make coverage determinations based on investigation/evaluation.
• Adjudicate settlements or denials up to designated authority level.
• Maintain properly documented claim files and meet quality/production goals.

Skills

Communication

Oral & Written

Analytical

Organizational

Interpersonal

Teamwork

Deadline Driven

Microsoft Office

Education

High School Diploma

Licensing (as required)

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 CompaniesCertified as a Great Place to WorkFortune Best Workplaces in Financial Services & InsuranceClaims Associate - ConsumerPRIMARY 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 RESPONSIBILITIESProcesses 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).QUALIFICATIONSEducation & LicensingHigh school diploma or GED required. Licenses as required or willingness/ability to move toward obtaining appropriate licensing as required.ExperienceOne (1) year of general office experience or equivalent combination of education and experience required. Claims industry experience preferred.Skills & KnowledgeKnowledge of first party property and casualty claim adjudication as applicable to line of businessGood oral and written communication, including presentation skillsPC literate, including Microsoft Office productsAnalytical and interpretive skillsGood organizational skillsGood interpersonal skillsAbility to work in a team environmentAbility to meet or exceed Performance CompetenciesWORK ENVIRONMENTWhen 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 deadlinesPhysical: Computer keyboarding, travel as requiredAuditory/Visual: Hearing, vision and talkingNOTE: 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.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.