Sedgwick
Sedgwick
Sedgwick provides technology-enabled risk, benefits, and integrated business solutions for organizations worldwide. Its work includes administering accident, health, disability, unemployment compensation, and liability claims, alongside building consulting, forensic accounting, forensic engineering, property restoration, brand protection, and loss prevention services. Sedgwick supports clients across industries including construction, consulting, healthcare, agriculture, and environmental services, with a stated focus on diversity, equity, inclusion, and environmental, social, and governance practices.

Workers' Compensation Claims Associate

Process and adjudicate lower-level workers' compensation claims for Sedgwick, including benefit determinations, documentation, payments, and claimant communications in an onsite role.

Description

  • Review reported workers' compensation claims and determine eligible benefits
  • Adjudicate claims according to company standards and industry best practices
  • Handle medical-only and minor lost-time claims under close supervision
  • Assist claims representatives, examiners, and leads with complex claims
  • Process claims, assess compensability and benefits, monitor reserves, and submit required state documentation
  • Communicate claim decisions and processing updates with claimants, clients, and medical contacts
  • Maintain complete claim files and accurate coding
  • Process routine payments, prescriptions, and status reports for lifetime or defined-period medical claims
  • Build and maintain professional client relationships

Requirements

  • High school diploma or GED required
  • Required licenses must be obtained as applicable
  • At least one year of general office experience or an equivalent combination of education and experience
  • Claims industry experience is preferred
  • Strong conceptual and clear-thinking skills
  • Sound judgment with troubleshooting, problem-solving, analytical, and discretionary abilities
  • Ability to manage work-related stress
  • Ability to balance multiple priorities
  • Reliable deadline management
  • Computer keyboarding proficiency
  • Willingness to travel as required

Benefits

  • Flexible scheduling options
  • Employee referral incentive program
  • Career development and advancement opportunities
  • Medical, dental, and vision coverage
  • 401(k) eligibility beginning on the first day

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