Remote NC Workers' Comp Claims Associate

Sedgwick Claims Management Services Ltd; North Carolina; Hybrid; USD 42,000 - 60,000; Full time

Job summary

Sedgwick, a global leader in risk and claims management, seeks a Claims Associate to analyze lower-level workers' compensation and medical-only claims to determine benefits due. This role supports adjudication within Sedgwick's standards and industry best practices and offers flexible work arrangements.

Qualified applicants have a high school diploma or GED; a bachelor's degree is preferred, with licenses and certifications as applicable.

Qualifications

• Education & Licensing: High School Diploma or GED required.
• Bachelor's degree from an accredited college or university preferred.
• Professional certification as applicable to line of business preferred.
• Experience: 1 years of claims management experience or equivalent combination of education and experience required.

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.

Education

High School Diploma or GED

Bachelor's degree from an accredited college or university preferred

Professional certification as applicable to line of business preferred

Job description

Sedgwick, a global leader in risk and claims management, seeks a Claims Associate to analyze lower-level workers' compensation and medical-only claims to determine benefits due. This role supports adjudication within Sedgwick's standards and industry best practices and offers flexible work arrangements.

Qualified applicants have a high school diploma or GED; a bachelor's degree is preferred, with licenses and certifications as applicable.