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.
Responsibilities:
— Analyze reported lower-level general liability claims to determine benefits due.
— Ensure ongoing adjudication of claims within company standards and industry best practices.
— Handle lower-level liability and/or physical damage claims under close supervision.
— Support other claims representatives, examiners, and leads with larger or more complex claims as necessary.
— Process general liability claims determining compensability and benefits due.
— Monitor reserve accuracy and file necessary documentation with state agencies.
— Communicate claim action/processing with claimant, client, and appropriate medical contacts.
— Ensure claim files are properly documented and claims coding is correct.
— May process routine payments, prescriptions, and status reports for lifetime medical claims and/or defined period medical claims.
— Maintain professional client relationships.
Requirements:
— High school diploma or GED required.
— Strong oral and written communication skills.
— Computer literate, including Microsoft Office.
— Organizational skills.
— Clerical or customer service experience or equivalent combination of education and experience preferred.
— Familiarity with medical terminology is a plus.
— Ability to handle heavy phone traffic.
— Ability to multitask, manage time, work in a fast-paced environment, and make decisions.
Benefits:
— Stable and consistent work environment in an office setting.
— Career development and promotional growth opportunities through increasing responsibilities.
— Diverse and comprehensive benefits package including medical, dental, vision, 401K with matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other voluntary benefits.
— Flexible work schedule.
— Referral incentive program.
Additional Information:
— Reasonable accommodations will be considered when applicable.
— Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
— Starting pay for this role is $21.00 per hour for the jurisdiction noted.
— Encouragement to apply even if experience does not perfectly align with qualifications.
— Sedgwick promotes a diverse, equitable, and inclusive workplace.
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Понятные задачи
Задачи включают анализ и обработку низкоуровневых претензий по ответственности, поддержку коллег с более сложными случаями, контроль правильности документации и коммуникацию с клиентами и медицинскими контактами.
Из объявления
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. … • Handles lower-level liability and/or physical damage claims under close supervision.