Claims Associate - Workers Compensation & Med Only | Jurisdiction: NC |Licensing: Required (Remote)

Sedgwick; Charlotte (NC); Híbrido; USD 42.000 - 66.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical benefits

Dental benefits

Vision benefits

401K on day one

Descripción de la vacante

Sedgwick in Charlotte, NC is seeking a Claims Associate for Workers’ Compensation to analyze and adjudicate lower-level claims and support ongoing processing. A high school diploma or GED is required; a bachelor’s degree is preferred.

The role offers flexible scheduling and a hybrid work arrangement. Responsibilities include determining benefits, adjusting medical-only and minor lost-time claims, and maintaining accurate claim documentation.

Formación

• High School Diploma or GED required.
• Bachelor's degree from an accredited college or university preferred.
• 1 year of claims management experience or equivalent education and experience required.
• Flexible work schedule.

Responsabilidades

• Analyze reported lower-level workers' compensation claims to determine benefits due; adjudication within company standards and industry best practices.
• 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; 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.

Educación

High School Diploma or GED

Bachelor's degree

Descripción del empleo

Fortune Best Workplaces in Financial Services & InsuranceClaims Associate - Workers Compensation

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. .Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.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 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.
• 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; 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.
• Education & Licensing: High School Diploma or GED required.
• Education & Licensing: Bachelor's degree from an accredited college or university preferred.
• Experience: 1 years of claims management experience or equivalent combination of education and experience required.
• Flexible work schedule.

Career development and promotional growth opportunities.

• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

excellent judgment, troubleshooting, problem solving, analysis, and discretion; Computer keyboarding, travel as requiredAuditory/Visual: Hearing, vision and talking

#claimsexaminer #claims #hybrid #LI-REMOTESedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.