Medical Only Claims Associate | Dedicated Client

Sedgwick Claims Management Services Ltd; Marlton (NJ); Hybrid; USD 29,000 - 42,000; Full time

Benefits offered by this job

Flexible schedule

Referral incentives

Career development

Medical, dental, vision, 401K

Job summary

Sedgwick is seeking driven individuals in Marlton, NJ for a Medical Only Claims Associate. You will analyze reported workers’ compensation claims to determine benefits due and support adjudication within company standards.

With a hybrid schedule (2 days in-office, remote where appropriate), you’ll collaborate with clients and colleagues, maintain accurate claim files, and grow professionally through our career development opportunities.

Qualifications

• High school diploma or GED required.
• One year of general office experience or equivalent combination of education and experience required.
• Claims industry experience preferred.

Responsibilities

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

Skills

Office experience

Claims industry experience

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 Medical Only Claims Associate | Dedicated Client

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? Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career? A stable and consistent work environment in an office and/or virtual setting 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 Role

We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

• 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; 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.

Work Location

Marlton, NJ - Hybrid Schedule (2 days in-office) if within commutable distance to office Remote if outside of commutable distance to office

Qualifications

• High school diploma or GED required.
• Licenses as required
• One (1) year of general office experience or equivalent combination of education and experience required.
• Claims industry experience preferred.

Benefits

• Flexible work schedule.
• Referral incentive program.
• Opportunity to work in an agile environment.
• Career development and promotional growth opportunities.
• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.
• A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

Pay

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location.

For the jurisdiction noted in this job posting only, the range of starting pay for this role is ($25.64/hour).

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

Auditory/Visual: Hearing, vision and talking

Equal Opportunity & Inclusion

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. You may be just the right candidate for this or other roles.

#claimsexaminer #claims #hybrid

About Sedgwick

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