Claims Associate – Workers Compensation

🔥 14 hours ago

🌲 North Carolina – Remote

🌲 North Carolina – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

📋 Claims Specialist

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Sedgwick

WebsiteLinkedInAll Job Openings

10,000+ employees

🏗️ Construction

💼 Consulting

🏥 Healthcare

Construction • Consulting • Healthcare

Sedgwick is a global provider of technology-enabled risk, benefits, and integrated business solutions. They help people and organizations by managing and mitigating risk with solutions in accident, health, disability, unemployment compensation, and liability claims administration, among others. Sedgwick offers services such as claims administration, building consulting, forensic accounting, and forensic engineering. Their specialties include property restoration, brand protection, and loss prevention across several industries, including agriculture, construction, and environmental sectors. The company emphasizes diversity, equity, and inclusion (DEI) as well as environmental, social, and governance (ESG) practices.

📋 Description

• Analyze reported lower-level workers compensation claims to determine benefits due • Ensure ongoing adjudication of claims within company standards and industry best practices • Adjust medical-only claims and minor lost-time workers compensation claims under close supervision • Support claims representatives, examiners, and leads with larger or more complex claims • Process workers compensation claims, determine compensability and benefits due, monitor reserve accuracy, and file necessary documentation with state agency • Communicate claim action and processing with claimants, clients, and appropriate medical contacts • Ensure claim files are properly documented and claims coding is correct • 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 • Bachelor's degree from an accredited college or university preferred • Professional certification as applicable to line of business preferred • 1 year of claims management experience or equivalent combination of education and experience required • 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 • Ability to meet deadlines • Computer keyboarding • Travel as required • Hearing, vision, and talking

🏖️ Benefits

• Flexible work schedule • Referral incentive program • Career development and promotional growth opportunities • Diverse and comprehensive benefits including medical, dental, vision, and 401K on day one • Reasonable accommodations considered when applicable and appropriate