Claims Associate Liability

Sedgwick Claims Management Services, Inc.

Telecommuter, GA

JOB DETAILS
SKILLS
Adjudication, Analysis Skills, Auditory, Best Practices, Claims Coding, Claims Management, Claims Processing, Communication Skills, Computer Skills, Customer Relations, Develop and Maintain Customers, Documentation, Financial Services, Identify Issues, Industry Standards, Insurance, Microsoft Office, Microsoft Product Family, Multitasking, Organizational Skills, Prescription Drugs, Presentation/Verbal Skills, Problem Solving Skills, Status Reports, Team Player, Time Management, Willing to Travel, Writing Skills
LOCATION
Telecommuter, GA
POSTED
8 days ago

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.

Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies

Certified as a Great Place to Work

Fortune Best Workplaces in Financial Services & Insurance

Claims Associate Liability

PRIMARY PURPOSE: To analyze reported lower-level level general liability claims to determine benefits due; and to ensure ongoing adjudication of claims within company standards and industry best practices.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

  • Handles lower-level liability and/or physical damage claims under close supervision.
  • Supports other claims representatives, examiners and leads with larger or more complex claims as necessary.
  • Processes general liability claims determining compensability and benefits due; monitors reserve accuracy, and files necessary documentation with state agency.
  • Communicates claim action/processing with claimant, client and appropriate medical contact.
  • Ensures claim files are properly documented and claims coding is correct.
  • May process routine payments and prescriptions and status reports for lifetime medical claims and/or defined period medical claims.
  • Maintains professional client relationships.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

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

QUALIFICATION

Education & Licensing

High school diploma or GED required. Licenses as required.

Experience

One (1) year of general office experience or equivalent combination of education and experience required. Claims industry experience preferred.

Skills & Knowledge

  • Excellent oral and written communication skills
  • PC literate, 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

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, 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

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Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

About the Company

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Sedgwick Claims Management Services, Inc.

Sedgwick Claims Management Services, Inc., is a leading global provider of technology-enabled risk and benefits solutions. At Sedgwick, caring countsSM; the company takes care of people and organizations by delivering cost-effective claims, productivity, managed care, risk consulting and other services through the dedication and expertise of nearly 15,000 colleagues in some 275 offices located in the U.S., Canada, the U.K and Ireland. Sedgwick facilitates financial and personal health and helps customers and consumers navigate complexity by designing and implementing customized programs based on proven practices and advanced technology that exceed expectations. Sedgwick’s majority shareholder is KKR; Stone Point Capital LLC, La Caisse de dépôt et placement du Québec (CDPQ) and other management investors are minority shareholders.

COMPANY SIZE
10,000 employees or more
INDUSTRY
Management Consulting Services
EMPLOYEE BENEFITS
Paid Sick Days, Performance Bonus, Professional Development, 401K, Employee Referral Program, Retirement / Pension Plans, Tuition Reimbursement, Work From Home, Life Insurance, Military Leave
FOUNDED
1969
WEBSITE
https://www.sedgwick.com/Pages/default.aspx