Claims Associate - Workers Compensation (100% Onsite)

Sedgwick Claims Management Services Ltd; Town of Wausau (WI); On-site; USD 42,000 - 64,000; Full time

Benefits offered by this job

Flexible schedule

Referral incentive

Career development

Benefits: medical, dental, vision, 401

K on day one

Job summary

Sedgwick is hiring a Claims Associate for Workers' Compensation on a 100% onsite basis in Wausau, WI. You will analyze reported lower-level workers compensation claims to determine benefits due and adjudicate claims to Sedgwick's standards.

Ideal candidate has a high school diploma or GED, 1 year of general office experience, and preferred claims experience. Flexible scheduling and comprehensive benefits are part of the offering.

Qualifications

• Education: High school diploma or GED required; Licenses as required.
• Experience: One year of general office experience or equivalent combo of education and experience; Claims industry experience preferred.

Responsibilities

• Adjusts medical-only and minor lost-time WC claims under close supervision.
• Supports other claims staff on larger or complex claims as needed.
• Processes WC claims, determines compensability and benefits, and files documents with state agencies.
• Communicates claim actions with claimant, client and medical contacts.
• Ensures claim files are properly documented and coding is correct.
• May process routine payments and prescriptions and status reports for medical claims.
• Maintains professional client relationships.

Skills

General office experience

Analytical thinking

Communication skills

Education

High school diploma or GED

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? 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. 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.

Work Locations

100% onsite at Wausau, WI, Des Moines, IA and Omaha NE Sedgwick offices.

Primary Purpose of the Role

To analyze reported lower-level workers compensation claims to determine benefits due; and to ensure ongoing adjudication of claims within company standards and industry best practices.

Essential Responsibilities

• Adjusts medical-only claims and minor lost-time workers compensation claims under close supervision.
• Supports other claims representatives, examiners and leads with larger or more complex claims as necessary.
• Processes workers compensation claims determining compensability and benefits due; monitors reserve accuracy, and files necessary documentation with state agency.
• Communicates claim action/processing with claimant, client and appropriate medical contact.
• Ensures claim files are properly documented and claims coding is correct.
• May process routine payments and prescriptions and status reports for lifetime medical claims and/or defined period medical claims.
• Maintains professional client relationships.

Qualifications

Education & Licensing: High school diploma or GED required. Licenses as required. Experience: One (1) year of general office experience or equivalent combination of education and experience required. Claims industry experience 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

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.

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.

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