Sedgwick
Sedgwick
Sedgwick oferă organizațiilor din întreaga lume soluții tehnologice pentru gestionarea riscurilor, beneficiilor și a unor servicii de afaceri integrate. Activitatea sa include administrarea dosarelor de daună pentru accidente, sănătate, dizabilitate, compensații de șomaj și răspundere, precum și servicii de consultanță, contabilitate judiciară, inginerie judiciară, restaurarea proprietăților, protejarea mărcilor și prevenirea pierderilor. Sedgwick sprijină clienți din sectoare precum construcțiile, consultanța, sănătatea, agricultura și serviciile de mediu, punând un accent declarat pe diversitate, echitate, incluziune și practicile de mediu, sociale și de guvernanță.

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.

Descriere

  • 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

Cerințe

  • 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

Beneficii

  • 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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