Claims Associate - Workers Compensation | Multi state Jurisdiction | Negaunee, MI or Seven Hills, OH (Hybrid)
Sedgwick is a global industry leader known for its excellence and customer service, seeking driven individuals for the Claims Associate role. The primary purpose of this position is to analyze reported lower-level workers compensation claims to determine benefits due and ensure ongoing adjudication 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
Skills
- High school diploma or GED required
- One (1) year of general office experience or equivalent combination of education and experience required
- Claims industry experience preferred
- Licensing: FL preferred; not required
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