Hybrid Workers' Comp Claims Specialist (Medical-Only)

Sedgwick; Chicago (IL); Hybrid; USD 27,000 - 38,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development and growth

Job summary

Sedgwick, a global leader in workers' compensation, seeks a Claims Associate - Medical Only for a hybrid Chicago role. You will analyze lower-level workers' compensation medical-only claims to determine benefits due and adjudicate claims in line with company standards.

Ideal candidates have a high school diploma or GED, at least one year of general office experience, and licensing knowledge for TX, MI, or FL. Sedgwick offers flexible schedules and comprehensive benefits.

Qualifications

• High school diploma or GED required; licenses as required.
• One year of general office experience; claims industry experience preferred.
• Licensing/jurisdiction knowledge: TX, MI, or FL.

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.

Skills

Office experience

Education

High school diploma or GED

Job description

Sedgwick, a global leader in workers' compensation, seeks a Claims Associate - Medical Only for a hybrid Chicago role. You will analyze lower-level workers' compensation medical-only claims to determine benefits due and adjudicate claims in line with company standards.

Ideal candidates have a high school diploma or GED, at least one year of general office experience, and licensing knowledge for TX, MI, or FL. Sedgwick offers flexible schedules and comprehensive benefits.