Specialty Operations Coordinator
Sedgwick
full-time
Posted on:
Location Type: Remote
Location: United States
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Salary
💰 $17 - $23 per hour
Job Level
About the role
- Analyze low- and mid-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 low- to mid-level lost-time workers compensation claims under close supervision.
- Support other claims staff with larger or more complex claims as necessary.
- Process workers compensation claims reviewing compensability, benefits due, and files necessary documentation with state agency.
- Communicate claim action/processing with appropriate parties including claimant, client, state agency, managed care organization, and appropriate medical contact.
- Ensure claims files are properly documented and claims coding is correct.
- Maintain professional client relationships.
- Coordinate actuarial/settlement issues impacting employers with rate and settlement departments.
Requirements
- High School diploma or GED required.
- Licenses as required.
- One (1) year of claims management experience or equivalent combination of education and experience required.
- Ability to meet or exceed Performance Competencies.
- Ability to work in a team environment.
- Good interpersonal skills.
- Strong organizational skills.
- Analytical and interpretive skills.
- PC literate, including Microsoft Office products.
- Excellent oral and written communication skills.
Benefits
- Three Medical and two dental plans to choose from.
- Tuition reimbursement eligible.
- 401K plan that matches 50% on every $ you put in up to the first 6% you save.
- 4 weeks PTO your first full year.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
claims managementadjudicationclaims processingclaims codinganalytical skillsinterpretive skills
Soft skills
interpersonal skillsorganizational skillscommunication skillsteamwork
Certifications
High School diplomaGED