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, Medical Only

Handle medical-only workers’ compensation claims at Sedgwick, a global claims management company. Assess compensability and benefits, maintain reserves and documentation, and ensure accurate claim coding.

Description

  • Review lower-level workers’ compensation claims and determine benefits payable
  • Adjudicate claims consistently with company standards and industry best practices
  • Adjust medical-only and minor lost-time claims under close supervision
  • Assist claims representatives, examiners, and leads with larger or more complex claims
  • Process workers’ compensation claims by assessing compensability and benefits payable
  • 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 claim coding accurate
  • Handle routine payments, prescriptions, and status reports for lifetime or defined-period medical claims
  • Build and maintain professional relationships with clients

Requirements

  • High school diploma or GED
  • Any required licenses; licensing is required in Texas, Michigan, or Florida
  • At least one year of general office experience, or an equivalent combination of education and experience
  • Claims industry experience is preferred
  • Knowledge of and experience with workers’ compensation
  • Ability to analyze claims and determine compensability and benefits payable
  • Ability to maintain accurate claim reserves, documentation, and coding
  • Clear, conceptual thinking skills
  • Strong judgment, troubleshooting, problem-solving, analytical, and discretion skills
  • Ability to manage work-related stress and multiple priorities
  • Ability to meet deadlines
  • Computer keyboarding skills
  • Hearing, vision, and speaking abilities

Benefits

  • Flexible work schedule
  • Referral incentive program
  • Opportunity to work in an agile environment
  • Career development and promotion opportunities
  • Medical, dental, and vision coverage
  • 401(k) from the first day
  • 401(k) matching
  • Paid time off
  • Disability insurance
  • Life insurance
  • Employee assistance program
  • Flexible spending account or health savings account
  • Additional voluntary benefits

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