Claims Associate – Workers Compensation, Multi State Jurisdiction
Sedgwick
full-time
Posted on:
Location Type: Hybrid
Location: Negaunee • Missouri, Ohio • 🇺🇸 United States
Visit company websiteSalary
💰 $16 - $22 per hour
Job Level
JuniorMid-Level
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
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