Claims Associate - Workers Compensation | Multi state Jurisdiction | Negaunee, MI or Seven Hills, OH (Hybrid)

Sedgwick is a global industry leader known for its excellence and customer service, seeking driven individuals for the Claims Associate role. The primary purpose of this position is to analyze reported lower-level workers compensation claims to determine benefits due and ensure ongoing adjudication within company standards.

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
• Processes workers compensation claims determining compensability and benefits due; monitors reserve accuracy, and files necessary documentation with state agency
• Communicates claim action/processing with claimant, client and appropriate medical contact
• Ensures claim files are properly documented and claims coding is correct
• May process routine payments and prescriptions and status reports for lifetime medical claims and/or defined period medical claims
• Maintains professional client relationships

Skills

• High school diploma or GED required
• One (1) year of general office experience or equivalent combination of education and experience required
• Claims industry experience preferred
• Licensing: FL preferred; not required

Benefits

• Flexible Work Schedule
• Referral Incentive Program
• Opportunity to work from home
• Career development and promotional growth opportunities
• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day 1
• Medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits

Company Overview