Analyze reported lower - level general liability claims for Sedgwick. Ensure ongoing adjudication of claims within company standards and industry best practices while working in a hybrid schedule.
About the role
- Claims Associate analyzing lower-level general liability claims at Sedgwick. Responsible for determining benefits, ongoing adjudication, and maintaining client relationships.
Responsibilities
- To analyze reported lower-level level general liability claims to determine benefits due
- Ensures ongoing adjudication of claims within company standards and industry best practices
- Supports other claims representatives, examiners and leads with larger or more complex claims as necessary
- Processes general liability 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
- Performs other duties as assigned
- Supports the organization's quality program(s)
Requirements
- High school diploma or GED required
- Licenses as required
- One (1) year of general office experience or equivalent combination of education and experience required
- Claims industry experience preferred
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
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
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