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.

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Claims Services Associate (Hybrid)

As a Claims Services Associate at Sedgwick, you’ll have the opportunity to take on new challenges and help solve complex problems.

Enjoy flexibility and autonomy in your daily work and your career path. This is a hybrid role 2 days in office and 3 days' work from home.

Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. 

ARE YOU AN IDEAL CANDIDATE? If you have 2+ years of experience in a claims support or administrative assistant role within insurance, legal or claims industries we want to talk to you! 

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

Provides initial research/data collection on claims file.Performs file audits according to jurisdictional standards as directed by state, carrier, or client.Reviews prior audit results, settled files, or files with no activity and identifies exceptions.Coordinates file retrieval and gathers data for submittal to management.Communicates with claim examiners to correct identified deficiencies by provides corrected payment amount and instructions regarding necessary state form filing.Monitors correction of audit exceptions ensuring completion and assists with filing of state forms and submitting payments as necessary.Researches exceptions on the state's quarterly compliance report and provides detailed response to management identifying trends in audit exceptions.Reviews and updates notes/diaries in claims management system as instructed.Coordinates jurisdictional training on state specific tools.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

Performs other duties as assigned.Supports the organization's quality program(s).

QUALIFICATION

Education & Licensing
High school diploma or GED required.

Experience
Two (2) years of claims experience or equivalent combination of education and experience required.

Skills & Knowledge

Knowledge of state workers' compensation statuteProficient math skillSkilled with Excel spreadsheetsExcellent oral and written communication, including presentation skillsPC literate, including Microsoft Office productsAbility to work in a team environmentAbility to meet or exceed Performance Competencies

WORK ENVIRONMENT
When applicable and appropriate, consideration will be given to reasonable accommodations. 

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

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.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.