Remote Workers' Comp Claims Associate

Sedgwick; Charlotte (NC); Hybrid; USD 42,000 - 66,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401K on day one

Job summary

Sedgwick in Charlotte, NC is seeking a Claims Associate for Workers’ Compensation to analyze and adjudicate lower-level claims and support ongoing processing. A high school diploma or GED is required; a bachelor’s degree is preferred.

The role offers flexible scheduling and a hybrid work arrangement. Responsibilities include determining benefits, adjusting medical-only and minor lost-time claims, and maintaining accurate claim documentation.

Qualifications

• High School Diploma or GED required.
• Bachelor's degree from an accredited college or university preferred.
• 1 year of claims management experience or equivalent education and experience required.
• Flexible work schedule.

Responsibilities

• Analyze reported lower-level workers' compensation claims to determine benefits due; adjudication 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; 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

Job description

Sedgwick in Charlotte, NC is seeking a Claims Associate for Workers’ Compensation to analyze and adjudicate lower-level claims and support ongoing processing. A high school diploma or GED is required; a bachelor’s degree is preferred.

The role offers flexible scheduling and a hybrid work arrangement. Responsibilities include determining benefits, adjusting medical-only and minor lost-time claims, and maintaining accurate claim documentation.