Claims Services Associate (Hybrid)

Sedgwick Claims Management Services • Southfield, MI

369d • Hybrid

About The Position

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive. A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work.

Requirements

• High school diploma or GED required.
• Two (2) years of claims experience or equivalent combination of education and experience required.
• Knowledge of state workers' compensation statute.
• Proficient math skills.
• Skilled with Excel spreadsheets.
• Excellent oral and written communication, including presentation skills.
• PC literate, including Microsoft Office products.
• Ability to work in a team environment.
• Ability to meet or exceed Performance Competencies.

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

What This Job Offers

• Industry: Professional, Scientific, and Technical Services
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees