Sedgwick is a global industry leader committed to providing excellence and customer service. The Claims Associate role involves analyzing lower-level workers compensation claims to determine benefits due and ensuring ongoing adjudication of claims within company standards.
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
- Performs other duties as assigned
- Supports the organization's quality program(s)
Skills
- 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 from home
- Career development and promotional growth opportunities
- A diverse and comprehensive benefits offering including medical, dental vision, 401K on day 1
- Medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits
Company Overview
Sedgwick is the world’s leading risk and claims administration partner, helping clients thrive by navigating the unexpected. It was founded in 1969, and is headquartered in Memphis, Tennessee, USA, with a workforce of 10001+ employees. Its website is http://www.sedgwick.com.
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