Claims Associate – Workers Compensation, Med Only

Sedgwick

Claims Associate adjudicating lower-level workers compensation claims at Sedgwick. Analyzing claims to determine benefits and ensuring adherence to company standards and best practices.

Posted 5/6/2026full-timeSyracuse • New York • 🇺🇸 United StatesJuniorMid-Level💰 $18 - $22 per hourWebsite

About the role

Key responsibilities & impact

Analyze reported lower-level workers compensation claims to determine benefits due.
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.
Support other claims representatives, examiners, and leads with larger or more complex claims as necessary.
Process workers compensation claims determining compensability and benefits due; monitors reserve accuracy, and files 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

What you’ll need

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

Comp & perks

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.

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

claims processingclaims adjudicationmedical claims adjustmentclaims codingreserve accuracy monitoringdocumentation filingpayment processing

Soft Skills

communicationclient relationship managementteam support

Certifications

high school diplomaGED