Claims Associate - Workers Compensation | Med Only | Jurisdiction: NY and PA | Licensing: NY Licensing preferred

About the role

Join Sedgwick, a global industry leader, where you can bring your big ideas to help solve problems for some of the world’s best brands. This role offers an opportunity to analyze and adjudicate complex workers compensation claims, support colleagues, and contribute to a rapidly growing, industry-leading company.

Responsibilities

• Adjusts medical-only claims and minor lost-time workers compensation claims under close supervision.
• Supports other claims representatives, examiners, and leads with larger or more complex claims as necessary.
• Determines compensability and benefits due for workers compensation claims, ensuring reserve accuracy and filing necessary documentation with state agencies.
• Communicates claim action/processing with claimants, clients, and appropriate medical contacts.
• Maintains proper documentation and ensures claims coding is accurate.
• Processes routine payments and status reports for lifetime and defined period medical claims.
• Maintains professional client relationships.

Requirements

• High school diploma or GED required.
• Licenses as required, with NY preferred.
• One (1) year of general office experience or equivalent combination of education and experience required.
• Claims industry experience preferred.
• Jurisdiction: NY and PA.
• Licensing: NY preferred.

Qualifications

• Education: High school diploma or GED.
• Licenses: Required.
• Experience: One (1) year of general office experience or equivalent combination of education and experience.
• Industry Experience: Claims industry experience preferred.
• Jurisdiction: NY and PA.
• Licensing: NY preferred.

Skills

• Computer keyboarding skills.
• Ability to handle work-related stress and meet deadlines.
• Clear and conceptual thinking ability.
• Excellent judgment and troubleshooting skills.
• Discretion and ability to handle multiple priorities simultaneously.

Benefits

• Flexible work schedule.
• Referral incentive program.
• Career development and promotional growth opportunities.
• A diverse and comprehensive benefits offering including medical, dental, vision, 401k, and matching.
• Paid time off.
• Disability and life insurance.
• Employee assistance program.
• Flexible spending or health savings account.
• Additional voluntary benefits.

Pay

The starting pay range for this role is $18.06 - $22.00 USD per hour.

Schedule

Flexible work schedule available.

Benefits

• Medical, dental, and vision coverage.
• 401(k) plan with company match.
• Paid time off.
• Disability and life insurance.
• Employee assistance program.
• Flexible spending or health savings account.
• Additional voluntary benefits.

Work Environment

• 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.