Claims Associate - Workers Compensation

Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career? 

• Career development and promotional growth opportunities through increasing responsibilities 

• A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs 

PRIMARY PURPOSE OF THE ROLE: To be oriented and trained as new industry professional with the ability to analyze workers compensation claims and determine benefits due.

ARE YOU AN IDEAL CANDIDATE? We are looking for an enthusiastic candidate to fill a Workers Compensation Associate position. Ideal candidates will thrive in a collaborative team environment, show motivation and drive in their work ethic, are customer-oriented, naturally empathic and solution-focused. 

ESSENTIAL RESPONSIBILITIES MAY INCLUDE 

• 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

QUALIFICATIONS

• Education & Licensing: High school diploma or GED required 

• Skills: Strong oral and written communication, computer literate – including Microsoft Office, organizational skills required 

• Experience: Clerical or customer service experience or equivalent combination of education and experience preferred 

TAKING CARE OF YOU

•  Flexible work schedule. 

• Ability to work in an agile environment

• Referral incentive program. 

• Career development and promotional growth opportunities. 

• A diverse and comprehensive benefit package offering including medical, dental vision, 401K.

WORK ENVIRONMENT REQUIREMENTS INCLUDE  

When applicable and appropriate, consideration will be given to reasonable accommodations. 

• Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines 

• Physical: Computer keyboarding

• Auditory/Visual: Hearing, vision and talking 

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is ($20-$24/hour). A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.