Claims Associate - Workers Compensation (Medical Only) - 100% onsite

Sedgwick; West Des Moines (IA); On-site; USD 38,000 - 48,000; Full time

Benefits offered by this job

Flexible schedule

Career development

Referral incentive program

Medical insurance

Dental insurance

Vision insurance

401K

Job summary

Sedgwick in West Des Moines, IA is seeking a Claims Associate for Workers Compensation (Medical Only) to analyze medical-only claims and ensure adjudication in line with company standards.

The ideal candidate thrives in a collaborative environment, is customer-oriented, empathetic, and capable of handling multiple tasks with attention to detail. The position is 100% onsite with a strong focus on professional growth and benefits.

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.

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

Skills

Customer orientation

Empathy

Communication

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 (Medical Only) - 100% onsite

Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career?

• Career development and promotional growth opportunities through increasing responsibilities
• A diverse and comprehensive benefits package to take care of your mental, physical, financial, and professional needs

PRIMARY PURPOSE OF THE ROLE: To analyze reported lower-level Medical Only workers compensation claims to determine benefits due; and to ensure ongoing adjudication of claims within company standards and industry best practices.

OFFICE LOCATION: 100% in office; 4200 University Avenue, Suite 317 West Des Moines, IA 50266

ARE YOU AN IDEAL CANDIDATE? We are looking for an enthusiastic candidate to fill a Workers Compensation Associate position. Ideal candidates will thrive in a collaborative team environment, show motivation and drive in their work ethic, are customer-oriented, naturally empathic and solution-focused.

ESSENTIAL RESPONSIBILITIES 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.
• Ability to work in an agile environment
• Referral incentive program.
• Career development and promotional growth opportunities.
• A diverse and comprehensive benefit package offering including medical, dental vision, 401K.

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

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.

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.