Claims Representative, IAP - Sedgwick Claims Management Services, Inc.

PRIMARY PURPOSE:  To be oriented and trained as new industry professional with the ability to analyze workers compensation, general liability or disability claims and determine benefits due.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Attendance and completion of designated classroom claims professional training program.
• Performs on-the-job training activities including:
  • Adjusting lost-time workers compensation claims under close supervision.  May be assigned medical only claims.
  • Adjusting low and mid-level liability and/or physical damage claims under close supervision.
  • Processing disability claims of minimal disability duration under close supervision.
  • Documenting claims files and properly coding claim activity.
  • Communicating claim action/processing with claimant and client.
  • Supporting other claims examiners and claims supervisors with larger or more complex claims as assigned.
• Participates in rotational assignments to provide temporary support for office needs.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

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

QUALIFICATIONS

Education & Licensing

Bachelor's or Associates degree from an accredited college or university preferred.

Experience:
Prior education, experience, or knowledge of:

• Customer Service
• Data Entry
• Medical Terminology (preferred)
• Computer Recordkeeping programs (preferred)
• Prior claims experience (preferred)

Additional helpful experience:

• State license if required (SIP, Property and Liability, Disability, etc.)
• WCCA/WCCP or similar designations for particular discipline
• For internal colleagues, completion of the Sedgwick Claims Progression Program

Skills and Knowledge

• Excellent oral and written communication, including presentation skills
• PC literate, including Microsoft Office products
• Analytical skills
• Ability to work in a team environment
• Ability 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 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

NOTE:  Credit security clearance, confirmed via a background credit check, is required for this position.

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.

#entrylevel

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $21.32-$29.85 per hour. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.