Claims Associate - Workers Comp | Jurisdiction: TX, OK, LA | 100% in office Plano, TX jobs in United States
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Sedgwick · 1 week ago

Claims Associate - Workers Comp | Jurisdiction: TX, OK, LA | 100% in office Plano, TX

Sedgwick is a global industry leader in claims management, and they are seeking a Claims Associate to adjudicate complex customer claims. The role involves delivering customer-facing solutions, supporting claims representatives, and ensuring proper documentation and processing of workers compensation claims.

BankingInsuranceRisk Management

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

Qualification

Claims processingJurisdiction knowledgeGeneral office experienceCustomer serviceCommunication skills

Required

High school diploma or GED required
One (1) year of general office experience or equivalent combination of education and experience required
Jurisdiction Knowledge: TX, OK, LA

Preferred

Claims industry experience preferred
Licensing: Preferred, not required

Benefits

Flexible work schedule.
Referral incentive program.
Career development and promotional growth opportunities.
A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

Company

Sedgwick

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Sedgwick is the world’s leading risk and claims administration partner, helping clients thrive by navigating the unexpected.

Funding

Current Stage
Late Stage
Total Funding
$1.5B
Key Investors
Altas PartnersLa Caisse
2024-09-12Private Equity· $1B
2018-12-01Private Equity
2018-09-12Acquired

Leadership Team

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Michael Arbour
Chairman & Chief Executive Officer
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Kalani Reelitz
Global Chief Financial Officer
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Company data provided by crunchbase