Overview

Claims Associate – Workers Compensation (Medical-Only) Jobs in West Des Moines at Sedgwick


Title: Claims Associate – Workers Compensation (Medical-Only)

Company: Sedgwick

Location: West Des Moines

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Claims Associate – Workers Compensation (Medical-Only)

IF YOU CARE, THERE’S A PLACE FOR YOU HERE

For a career path that is both challenging and rewarding, join Sedgwick’s talented team of 27,000 colleagues around the globe. Sedgwick is a leading provider of technology-enabled risk, benefits and integrated business solutions. Taking care of people is at the heart of everything we do. Millions of people and organizations count on Sedgwick each year to take care of their needs when they face a major life event or something unexpected happens. Whether they have a workplace injury, suffer property or financial loss or damage from a natural or manmade disaster, are involved in an auto or other type of accident, or need time away from work for the birth of a child or another medical situation, we are here to provide compassionate care and expert guidance. Our clients depend on our talented colleagues to take care of their most valuable assets—their employees, their customers and their property. At Sedgwick, caring counts®. Join our team of creative and caring people of all backgrounds, and help us make a difference in the lives of others.

For more than 50 years, Sedgwick has been helping employers answer virtually every question there is about workers’ compensation. We have experience in nearly every type of industry and region and provide the industry’s broadest range of programs and services.

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

BENEFITS
Competitive salary

Flexible work schedule
Referral Incentive Program

Internal career progression and development

Benefits eligibility and 401(k) with company match day 1

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

Adjusts medical-only claims and minor lost-time workers compensation claims under close supervision.

Supports other claims representatives, examiners and leads with larger or more complex claims as necessary.

Processes workers compensation 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).

QUALIFICATIONS

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

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