Medical-Only Workers' Comp Claims Associate

Sedgwick Claims Management Services Ltd; Dublin (OH); Hybrid; USD 25,000 - 36,000; Full time

Benefits offered by this job

Flexible schedule

Referral program

Agile environment

Career growth

Benefits package

Job summary

Sedgwick is hiring a Dublin, OH-based Claims Associate focused on medical-only workers compensation claims. The role supports adjudication, communicates with claimants and clients, and ensures accurate documentation and coding. Hybrid schedule available for those within commuting distance.

Ideal candidates have medical terminology knowledge, claims exposure, and a year of office experience. Jurisdictions include OH and surrounding states; comprehensive benefits are provided.

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.
• Medical terminology background.
• Claims experience preferred.
• Jurisdictions: OH, IN, AL, NC, SC, GA.

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

Medical terminology

Claims experience

Office experience

Education

High school diploma or GED

Job description

Sedgwick is hiring a Dublin, OH-based Claims Associate focused on medical-only workers compensation claims. The role supports adjudication, communicates with claimants and clients, and ensures accurate documentation and coding. Hybrid schedule available for those within commuting distance.

Ideal candidates have medical terminology knowledge, claims exposure, and a year of office experience. Jurisdictions include OH and surrounding states; comprehensive benefits are provided.