Claims Associate

Sedgwick • Bartlesville, OK

5d

About The Position

The Claims Associate analyzes reported lower-level workers compensation claims to determine benefits due and ensure ongoing adjudication within company standards and industry best practices. The role adjusts medical-only and minor lost-time claims under close supervision, supports other claims professionals with larger or more complex claims, and maintains professional client relationships. The position also supports the organization’s quality programs. Duties may vary, and management may add or change responsibilities.

Requirements

• One year of general office experience or an equivalent combination of education and experience.
• High school diploma or GED.
• Licenses as required.
• Excellent oral and written communication skills.
• Computer literacy, including Microsoft Office products.
• Analytical and interpretive skills.
• Strong organizational skills.
• Good interpersonal skills.
• Ability to work in a team environment.
• Ability to meet or exceed Performance Competencies.

Nice To Haves

• Claims industry experience preferred.

Responsibilities

• Adjusts medical-only workers compensation claims and minor lost-time claims under close supervision.
• Supports other claims representatives, examiners, and leads with larger or more complex claims as needed.
• Processes workers compensation claims, determines compensability and benefits due, monitors reserve accuracy, and files required documentation with state agencies.
• Communicates claim actions and processing with claimants, clients, and appropriate medical contacts.
• Ensures claim files are properly documented and claims coding is correct.
• May process routine payments and prescriptions and prepare status reports for lifetime medical claims or defined-period medical claims.
• Maintains professional client relationships.
• Performs other duties as assigned.
• Supports the organization's quality program(s).

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED