Claims Associate - Consumer

Sedgwick; Oregon; Hybrid; USD 42,000 - 54,000; Full time

Job summary

Sedgwick in Oregon seeks an Insurance Claims Associate to process first party property claims and determine benefits due under client programs. You will ensure timely payments, document claim files, and deliver superior customer service while meeting quality and production goals.

The role requires a high school diploma, 1 year of office experience, knowledge of property claim adjudication, MS Office, and strong communication.

Qualifications

• Knowledge of first party property and casualty claim adjudication.
• Strong oral and written communication skills, including presentation.
• Proficient with PC and Microsoft Office products.
• Analytical and interpretive skills; ability to document and track information.

Responsibilities

• Process first party property claims based on client program specifications.
• Make coverage determinations based on investigation/evaluation.
• Adjudicate settlements or denials within authority levels.
• Handle high volume of claims, calls and correspondence with accurate documentation.

Skills

Property claims

Claim adjudication

Communication skills

PC literacy

Analytical skills

Organizational skills

Team player

Education

High school diploma or GED

1 year office experience

Tools

Microsoft Office

Job description

Insurance Claims 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.

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 & Insurance

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 & 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 & 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.

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.