Claims Associate - Workers Compensation (100% Onsite)

Sedgwick Claims Management Services Inc.; Meridian (ID); On-site; USD 23,000 - 34,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development and promotional成长

Job summary

Sedgwick is seeking an onsite Claims Associate for Workers’ Compensation in Nevada. You will oversee components of the claims process, ensure timely actions, and support regulatory filings while collaborating with examiners and leadership.

The role emphasizes accuracy, compliance, and timely resolution in a dynamic environment. Flexible work schedule, referral incentives, career development, and a comprehensive benefits package are offered.

Qualifications

• High School Diploma or GED required.
• Bachelor's degree preferred.
• Professional certification as applicable to line of business preferred.
• Must possess or be able to obtain the applicable Nevada Workers’ Compensation claims certification/credential required for the position.
• 1 year of claims management experience or equivalent combination of education and experience required.
• Experience supporting or managing claim activities involving regulatory timeframes, payments, filings, denials, settlements, or similar claim functions strongly preferred.

Responsibilities

• Tracks and reports on timeliness of key aspects of the Workers’ Compensation claims process, including denials, settlements, required timeframes, payments, filings, and other assigned claim activities.
• Monitors claims to ensure required actions, payments, documentation, and filings are completed accurately and within established timeframes.
• Provides oversight of specific portions of the claims process to help ensure compliance with Nevada Workers’ Compensation requirements and internal standards.
• Reviews claim activity and documentation to identify outstanding or time-sensitive items requiring action or follow-up.
• Coordinates with claims examiners, leadership appropriate parties to support timely completion of claim activities.
• Assists with the preparation, review, and submission of required claim documentation and regulatory filings.
• Monitors the timely processing of benefits and payments and follows up on outstanding items as appropriate.
• Supports the handling of denials and settlements by ensuring required documentation, notices, approvals, and related activities are completed within applicable timeframes.
• Identifies potential delays, missing information, or process issues and works with the appropriate parties toward resolution.
• Performs other duties as assigned.
• Supports the organization’s quality and compliance programs.
• Assists with additional Workers’ Compensation activities as business needs require.

Education

High School Diploma or GED

Bachelor's degree

Professional certification

Nevada Workers’ Compensation claims certification/credential

1 year of claims management experience

Experience with regulatory timeframes, payments, filings, denials, settlements

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 - Workers Compensation (100% Onsite) Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands? Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations. Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. Leverage Sedgwick’s broad, global network of experts to both learn from and to share your insights. Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career. Enjoy flexibility and autonomy in your daily work, your location, and your career path. Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

ARE YOU AN IDEAL CANDIDATE?

We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

PRIMARY PURPOSE OF THE ROLE

To oversee components of the Nevada Workers’ Compensation claims process, ensuring claim activities are completed accurately and within applicable timeframes. This role provides focused oversight of specific claim functions.

ESSENTIAL RESPONSIBLITIES MAY INCLUDE

• Tracks and reports on timeliness of key aspects of the Workers’ Compensation claims process, including denials, settlements, required timeframes, payments, filings, and other assigned claim activities.
• Monitors claims to ensure required actions, payments, documentation, and filings are completed accurately and within established timeframes.
• Provides oversight of specific portions of the claims process to help ensure compliance with Nevada Workers’ Compensation requirements and internal standards.
• Reviews claim activity and documentation to identify outstanding or time-sensitive items requiring action or follow-up.
• Coordinates with claims examiners, leadership appropriate parties to support timely completion of claim activities.
• Assists with the preparation, review, and submission of required claim documentation and regulatory filings.
• Monitors the timely processing of benefits and payments and follows up on outstanding items as appropriate.
• Supports the handling of denials and settlements by ensuring required documentation, notices, approvals, and related activities are completed within applicable timeframes.
• Identifies potential delays, missing information, or process issues and works with the appropriate parties toward resolution.

ADDITIONAL FUNCTIONS AND RESPONSIBILITIES

• Performs other duties as assigned.
• Supports the organization’s quality and compliance programs.
• Assists with additional Workers’ Compensation activities as business needs require.

QUALIFICATIONS

• Education & Licensing: High School Diploma or GED required.
• Bachelor's degree from an accredited college or university preferred.
• Professional certification as applicable to line of business preferred.
• Must possess or be able to obtain the applicable Nevada Workers’ Compensation claims certification/credential required for the position.
• Experience: 1 years of claims management experience or equivalent combination of education and experience required.
• Experience supporting or managing claim activities involving regulatory timeframes, payments, filings, denials, settlements, or similar claim functions strongly preferred.

TAKING CARE OF YOU

• Flexible work schedule.
• Referral incentive program.
• Career development and promotional growth opportunities.
• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

WORK ENVIRONMENT REQUIREMENTS INCLUDE

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 As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is ($17.00 - $25.00). A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

#claimsexaminer #claims #hybrid #LI-REMOTE

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.

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