Medical-Only Claims Specialist – Hybrid Worker’s Comp

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

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401K on day one

PTO

Job summary

Sedgwick Claims Management Services in Chicago, IL, is hiring a Claims Associate for Workers' Comp Med Only in a hybrid role. Analyze reported lower-level claims to determine benefits and ensure adjudication aligns with standards and best practices.

Ideal candidates have at least one year of general office experience, a high school diploma or GED, and licensing knowledge for TX, MI, or FL. The position offers growth, training, and a comprehensive benefits package.

Qualifications

• One year of general office experience or equivalent combination of education and experience.
• Licensing / Jurisdiction Knowledge: Licensing required, 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.
• May process routine payments and prescriptions and status reports for lifetime medical claims and/or defined period medical claims.
• Maintains professional client relationships.

Skills

General office experience

Education

High school diploma or GED

Job description

Sedgwick Claims Management Services in Chicago, IL, is hiring a Claims Associate for Workers' Comp Med Only in a hybrid role. Analyze reported lower-level claims to determine benefits and ensure adjudication aligns with standards and best practices.

Ideal candidates have at least one year of general office experience, a high school diploma or GED, and licensing knowledge for TX, MI, or FL. The position offers growth, training, and a comprehensive benefits package.