Description
By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected.
We're looking for a Claims Associate to analyze reported lower-level workers compensation and medical only claims to determine benefits due; and to ensure ongoing adjudication of claims within company standards and industry best practices.
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.
Qualifications:
- 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.
- 1 year of claims management experience or equivalent combination of education and experience required.
- Jurisdiction: NC
- Licensing: NC or home state reciprocal required
Benefits:
- Flexible work schedule.
- Referral incentive program.
- Career development and promotional growth opportunities.
- A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.