Claims Associate – Workers Compensation, Multi State Jurisdiction
Sedgwick
full-time
Posted on:
Location Type: Hybrid
Location: Negaunee • Missouri • Ohio • United States
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Salary
💰 $16 - $22 per hour
About the role
- Analyze reported lower-level workers compensation claims to determine benefits due
- Ensure ongoing adjudication of claims within company standards and industry best practices
- Adjust medical-only claims and minor lost-time workers compensation claims under close supervision
- Support other claims representatives, examiners, and leads with larger or more complex claims as necessary
- Process workers compensation claims determining compensability and benefits due; monitor reserve accuracy, and file necessary documentation with state agency
- Communicate claim action/processing with claimant, client, and appropriate medical contact
- Ensure 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
- Maintain professional client relationships
Requirements
- 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
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
claims processingclaims adjudicationmedical claims adjustmentclaims codingreserve accuracy monitoringdocumentation filingbenefits determinationcompensability analysispayment processingstatus reporting
Soft Skills
communicationclient relationship managementteam supportattention to detailorganizational skills
Certifications
high school diplomaGED