About The Position
Sedgwick is seeking a Workers Compensation Claims Associate to analyze reported lower-level workers compensation claims, 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, with support available from other claims representatives, examiners, and leads for larger or more complex claims. The position is based in Dublin, Ohio, with a hybrid schedule for employees within commuting distance of the office and remote work for those outside that distance. The role is intended for driven individuals who embody Sedgwick’s caring counts model and values of empathy, accountability, collaboration, growth, and inclusion. Flexible scheduling and career development opportunities are offered.
Requirements
- High school diploma or GED.
- Licenses as required.
- One year of general office experience or an equivalent combination of education and experience.
- Medical terminology background.
Nice To Haves
- Claims industry experience.
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.
Benefits
- Flexible work schedule.
- Referral incentive program.
- Career development and promotional growth opportunities.
- Medical, dental, and vision coverage.
- 401(k) and matching.
- Paid time off (PTO).
- Disability insurance.
- Life insurance.
- Employee assistance program.
- Flexible spending account or health savings account.
- Additional voluntary benefits.
- Opportunity to work in an agile environment.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
