Note: The job is a remote job and is open to candidates in USA. Sedgwick is a company dedicated to helping those facing unexpected challenges, and they are seeking a Specialty Operations Coordinator. The role involves analyzing workers compensation claims and ensuring proper adjudication according to company standards and best practices.
Responsibilities
- Adjusts medical-only claims and low- to mid-level lost-time workers compensation claims under close supervision
- Supports other claims staff with larger or more complex claims as necessary
- Processes workers compensation claims reviewing compensability, benefits due, and files necessary documentation with state agency
- Communicates claim action/processing with appropriate parties including, but not limited to: claimant, client, state agency, managed care organization and appropriate medical contact
- Ensures claims files are properly documented and claims coding is correct
- Maintains professional client relationships
- Coordinates actuarial/settlement issues impacting employers with rate and settlement departments
- Performs other duties as assigned
- Supports the organization's quality program(s)
Skills
- High School diploma or GED required
- Licenses as required
- One (1) year of claims management experience or equivalent combination of education and experience required
- Ability to meet or exceed Performance Competencies
- Ability to work in a team environment
- Good interpersonal skills
- Strong organizational skills
- Analytical and interpretive skills
- PC literate, including Microsoft Office products
- Excellent oral and written communication skills
Benefits
- Three Medical, and two dental plans to choose from.
- Tuition reimbursement eligible.
- 401K plan that matches 50% on every $ you put in up to the first 6% you save.
- 4 weeks PTO your first full year.
- Comprehensive benefits package including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.
Company Overview
Sedgwick is the world’s leading risk and claims administration partner, helping clients thrive by navigating the unexpected. It was founded in 1969, and is headquartered in Memphis, Tennessee, USA, with a workforce of 10001+ employees. Its website is http://www.sedgwick.com.
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