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Specialty Operations Coordinator
SedgwickAnalyze workers compensation claims for appropriate benefits while adhering to company standards. Collaborate within a team environment to manage claims efficiently and accurately.
About the role
Key responsibilities & impact- 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, but not limited to: 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
What you’ll need- High School diploma or GED required
- Licenses as required
- One (1) year of claims management experience or equivalent combination of education and experience required
- PC literate, including Microsoft Office products
- Analytical and interpretive skills
- Strong organizational skills
- Good interpersonal skills
- Ability to work in a team environment
Benefits
Comp & perks- Three Medical plans to choose from
- 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
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
claims managementworkers compensation claimsclaims adjudicationclaims processingclaims codingdocumentationanalytical skillsinterpretive skills
Soft Skills
organizational skillsinterpersonal skillsteamwork
Certifications
High School diplomaGED