Claims Associate - Workers Compensation (Med Only) - Remote

About the Role

Join Sedgwick, a global industry leader, and be part of a meaningful mission supporting people facing the unexpected. As a Claims Associate specializing in Workers Compensation (Medical Only), you will analyze medical-only claims to determine benefits due while ensuring adherence to service expectations, industry best practices, and client requirements. This role offers flexibility, autonomy, and opportunities for career growth within a rapidly expanding company known for excellence and customer service.

Responsibilities

• Adjust medical-only and minor lost-time workers compensation claims under close supervision.
• Support other claims representatives, examiners, and leads with larger or more complex claims as needed.
• Process workers compensation claims, determine compensability and benefits due, monitor reserve accuracy, and file necessary documentation with state agencies.
• Communicate claim actions and processing with claimants, clients, and medical contacts.
• Ensure proper documentation of claim files and accuracy of claims coding.
• Process routine payments, prescriptions, and status reports for lifetime medical claims and/or defined period medical claims.
• Maintain professional client relationships.
• Perform other duties as assigned and support the organization’s quality programs.

Requirements

• High School Diploma or GED required; Bachelor’s degree from an accredited college or university preferred.
• Professional certification applicable to the line of business preferred.
• One (1) year of general office experience or equivalent combination of education and experience required.
• Claims industry experience preferred.

Skills

• Clear and conceptual thinking ability with excellent judgment, troubleshooting, problem-solving, and analytical skills.
• Ability to handle work-related stress, multiple priorities, and meet deadlines.
• Proficiency in computer keyboarding.
• Effective communication skills (hearing, vision, and talking).
• Travel as required.

Benefits

• Flexible work schedule.
• Referral incentive program.
• Agile work environment.
• Career development and promotional growth opportunities.
• Comprehensive benefits offering, including medical, dental, vision, and 401K (available on day one).

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. Candidates with diverse skills, knowledge, and experiences are encouraged to apply, even if their background does not perfectly align with every qualification.