Claims Associate - Workers Compensation (100% Onsite)

Sedgwick; United States; On-site; USD 45,000 - 65,000; Full time

Benefits offered by this job

Flexible schedule

Referral program

Career development

Benefits: medical, dental, vision, 401

K on day one

Job summary

Sedgwick is recruiting for a Claims Associate - Workers' Compensation, a 100% onsite role in the United States. You will analyze reported lower-level claims to determine benefits due and ensure adjudication aligns with company standards and industry best practices.

The position is located in onsite Sedgwick offices in Wausau, WI; Des Moines, IA; and Omaha, NE. The ideal candidate will have a high school diploma or GED, about one year of general office experience, and preferred workers'

Qualifications

• High school diploma or GED is required; Licenses as required.
• One year of general office experience or an equivalent combination of education and experience is required; claims industry experience is preferred.
• Experience in workers compensation claims is a plus.

Responsibilities

• Adjust medical-only claims and minor lost-time workers compensation claims under close supervision.
• Support other claims representatives, examiners and leads with larger or more complex claims as necessary.
• Process workers compensation claims, determine compensability and benefits due; monitor reserve accuracy and file necessary documentation with state agency.
• Communicate claim actions with claimants, clients and appropriate medical contacts.
• Ensure claim files are properly documented and claim coding is correct.
• May process routine payments and prescriptions and status reports for lifetime medical claims and defined period medical claims.
• Maintain professional client relationships.

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 RESPONSIBLITIES MAY INCLUDE

• 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 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

Sedgwickis 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.