Workers Compensation Claims Associate
Sedgwick
full-time
Posted on:
Location Type: Remote
Location: Florida • New York • United States
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Salary
💰 $24 - $26 per hour
About the role
- To analyze reported lower-level workers compensation claims to determine benefits due; and to ensure ongoing adjudication of claims within company standards and industry best practices.
- 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.
Requirements
- High school diploma or GED required.
- Licenses as required.
- Florida, New York and Vermont Workers Compensation License preferred.
- New hire will need to obtain license in the state they reside, and in Florida and New York within 90 days.
- One (1) year of general office experience or equivalent combination of education and experience required.
- Claims industry experience preferred.
- Excellent oral and written communication skills
- PC literate, including Microsoft Office products
- Analytical and interpretive skills
- Strong organizational skills
- Good interpersonal skills
- Ability to work in a team environment
- Ability to meet or exceed Performance Competencies
Benefits
- medical
- dental
- vision
- 401k and matching
- PTO
- disability and life insurance
- employee assistance
- flexible spending or health savings account
- other additional voluntary benefits
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
claims processingclaims adjudicationmedical-only claims adjustmentreserve accuracy monitoringclaims codingroutine payments processingprescription processing
Soft skills
oral communicationwritten communicationanalytical skillsinterpretive skillsorganizational skillsinterpersonal skillsteamworkperformance competency
Certifications
Florida Workers Compensation LicenseNew York Workers Compensation LicenseVermont Workers Compensation LicenseGED