Medical Only Claims Associate | Dedicated Client

Sedgwick•Marlton, NJ

7d•Hybrid

About The Position

The Medical Only 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 claims and minor lost-time claims under close supervision, supports other claims staff with larger or more complex claims, and helps maintain accurate, documented claim files and professional client relationships. The position is based in Marlton, New Jersey, with a hybrid schedule of two days in the office for employees within commuting distance; it is remote for employees outside commuting distance.

Requirements

High school diploma or GED.
Licenses as required.
One year of general office experience or an equivalent combination of education and experience.
Clear and conceptual thinking, sound judgment, troubleshooting, problem-solving, analysis, and discretion.
Ability to handle work-related stress, manage multiple priorities simultaneously, and meet deadlines.
Computer keyboarding ability.
Hearing, vision, and talking ability.

Nice To Haves

Claims industry experience preferred.

Responsibilities

Adjust medical-only claims and minor lost-time workers’ compensation claims under close supervision.
Support other claims representatives, examiners, and leads with larger or more complex claims as necessary.
Process workers’ compensation claims, determine compensability and benefits due, monitor reserve accuracy, and file necessary documentation with state agencies.
Communicate claim actions and processing with claimants, clients, and appropriate medical contacts.
Ensure claim files are properly documented and claims coding is correct.
Process routine payments and prescriptions and prepare status reports for lifetime medical claims and/or defined-period medical claims, as applicable.
Maintain professional client relationships.