Claims Associate - Consumer (Bilingual)

Sedgwick Claims Management Services Ltd; Seven Hills (OH); On-site; USD 42,000 - 56,000; Full time

Job summary

Sedgwick is seeking a Claims Associate - Consumer (Bilingual) to process first party property claims and determine benefits under client programs. You will read claims, perform investigations, and make timely settlements or denials with attention to accuracy.

You will handle a high volume of inquiries, maintain organized files, and provide superior customer service while supporting Sedgwick’s quality and compliance standards. Fluency in professional Spanish is required.

Qualifications

• High school diploma or GED required.
• 1 year general office experience or equivalent required.
• Experience in claims preferred.

Responsibilities

• Processes first party property claims based on basic coverage per client program.
• Makes coverage determinations after investigations/evaluations.
• Adjudicates settlements or denials up to designated authority level.
• Handles high volume of claims, calls and correspondence meeting quality and deadlines.

Skills

First party property

Casualty claim adjudication

Oral and written communication

PC literate

Analytical skills

Organizational skills

Teamwork

Time management

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 (Bilingual) 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. **Ability to read, write and converse with fluency in professional Spanish.** 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 Ability to read, write and converse with fluency in professional Spanish 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. 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. Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company’s expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see sedgwick.com