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 workers’ compensation claims, including medical-only and minor lost-time cases, for Sedgwick in an on-site role. The work includes benefits determinations, claim records, routine payments, and communications with claimants, clients, and medical contacts.

Description

  • Review lower-level workers’ compensation claims to determine benefits owed
  • Adjudicate claims in line with company standards and industry practices
  • Adjust medical-only and minor lost-time claims under close supervision
  • Assist claims representatives, examiners, and leads with larger or more complex cases
  • Process claims and determine compensability and benefits owed
  • Check reserve accuracy and submit required documents to state agencies
  • Update claimants, clients, and relevant medical contacts on claim actions and processing
  • Keep claim files complete and ensure coding is accurate
  • Handle routine payments, prescriptions, and status reports for lifetime or defined-period medical claims
  • Build and maintain professional client relationships
  • Contribute to the organization’s quality programs
  • Carry out other assigned duties

Requirements

  • High school diploma or GED
  • Required licenses, as applicable
  • At least one year of general office experience, or an equivalent combination of education and experience
  • Claims industry experience is preferred
  • Ability to think clearly and conceptually
  • Strong judgment and skills in troubleshooting, problem solving, analysis, and discretion
  • Ability to manage work-related stress
  • Ability to handle several priorities at once
  • Ability to meet deadlines
  • Computer keyboarding ability
  • Ability to hear, see, and speak
  • Willingness and ability to travel as required

Benefits

  • Flexible work schedule
  • Referral incentive program
  • Career development and opportunities for advancement
  • Medical, dental, and vision coverage starting on the first day
  • 401(k) plan with matching starting on the first day
  • Paid time off
  • Disability and life insurance
  • Employee assistance program
  • Flexible spending account or health savings account
  • Additional voluntary benefits
  • Reasonable accommodations where applicable and appropriate

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