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Claims Associate - Workers Compensation - Richmond, VA - Hybrid - 2 -3 days in office per week

100% Remote Full-time Open now

Sedgwick is a global industry leader committed to providing excellence and customer service. The Claims Associate role involves analyzing lower-level workers compensation claims to determine benefits due and ensuring ongoing adjudication of claims 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
  • Performs other duties as assigned
  • Supports the organization's quality program(s)

Skills

  • 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
  • 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

  • Sedgwick is the world’s leading risk and claims administration partner, helping clients thrive by navigating the unexpected. It was founded in 1969, and is headquartered in Memphis, Tennessee, USA, with a workforce of 10001+ employees. Its website is http://www.sedgwick.com.
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