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Claims Associate - Workers Comp Med Only ( Hybrid/Agile - Must be local to Sedgwick office)
Claims Associate - Workers Comp Med Only ( Hybrid/Agile - Must be local to Sedgwick office)Sedgwick • Lansing, MI, US
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Claims Associate - Workers Comp Med Only ( Hybrid / Agile - Must be local to Sedgwick office)

Claims Associate - Workers Comp Med Only ( Hybrid / Agile - Must be local to Sedgwick office)

Sedgwick • Lansing, MI, US
3 days ago
Job type
  • Full-time
Job description

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.

Claims Associate – Workers Comp Med Only (Hybrid / Agile – Must be local to Sedgwick office)

Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world's best brands?

  • Apply your knowledge and experience to adjudicate complex customer claims in the context of an energetic culture.
  • Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world's most respected organizations.
  • Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
  • Leverage Sedgwick's broad, global network of experts to both learn from and to share your insights.
  • Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.
  • Enjoy flexibility and autonomy in your daily work, your location, and your career path.
  • Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

ARE YOU AN IDEAL CANDIDATE?

We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

PRIMARY PURPOSE

To analyze low level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

  • Adjust low level medical-only claims and minor lost-time workers compensation claims under close supervision.
  • Support other claims representatives, examiners and leaders with larger or more complex claims as necessary.
  • Process workers compensation claims determining compensability and benefits due; monitor reserve accuracy, and file necessary documentation with state agency.
  • Communicate claim action / processing with claimant, client and appropriate medical contact.
  • Ensure claim files are properly documented and claims coding is correct.
  • Process routine payments and prescriptions and status reports for lifetime medical claims and / or defined period medical claims.
  • Maintain professional client relationships.
  • ADDITIONAL FUNCTIONS and RESPONSIBILITIES

  • Perform other duties as assigned.
  • Support the organization's quality program(s).
  • Travel as required.
  • QUALIFICATIONS

    Education & Licensing

    High school diploma or GED; Licenses as required.

    Experience

    One (1) year of general office experience or equivalent combination of education and experience required. Claims industry experience preferred.

    TAKING CARE OF YOU

  • Flexible work schedule.
  • Referral incentive program.
  • Career development and promotional growth opportunities.
  • A diverse and comprehensive benefits offering including medical, dental, vision, 401K on day one.
  • The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

    Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

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