Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.
A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work.
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PRIMARY PURPOSE: To analyze low- and mid-level workers compensation claims to determine benefits due; and to ensure ongoing adjudication of claims within company standards and industry best practices.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Adjusts medical-only claims and low- to mid-level lost-time workers compensation claims under close supervision.Supports other claims staff with larger or more complex claims as necessary.Processes workers compensation claims reviewing compensability, benefits due, and files necessary documentation with state agency.Communicates claim action/processing with appropriate parties including, but not limited to: claimant, client, state agency, managed care organization and appropriate medical contact.Ensures claims files are properly documented and claims coding is correct.Maintains professional client relationships.Coordinates actuarial/settlement issues impacting employers with rate and settlement departments.ADDITIONAL FUNCTIONS and RESPONSIBILITIES
Performs other duties as assigned.Supports the organization's quality program(s).QUALIFICATIONS
Education & Licensing
High School diploma or GED required. Licenses as required.
Experience
One (1) year of claims management experience or equivalent combination of education and experience required.
Skills & Knowledge
Excellent oral and written communication skillsPC literate, including Microsoft Office productsAnalytical and interpretive skillsStrong organizational skillsGood interpersonal skillsAbility to work in a team environmentAbility to meet or exceed Performance CompetenciesWORK ENVIRONMENT
When applicable and appropriate, consideration will be given to reasonable accommodations.
Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
Physical: Computer keyboarding, travel as required
Auditory/Visual: Hearing, vision and talking
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.