Claims Associate - Workers Compensation… at Sedgwick · Honolulu

Summary: Sedgwick is a global industry leader committed to excellence and customer service. The Claims Associate role involves analyzing low-level workers compensation claims to determine benefits due and ensuring ongoing adjudication of claims within company standards. 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) - Travels as required Required Qualifications: - High school diploma or GED - Licenses as required - One (1) year of general office experience or equivalent combination of education and experience required Preferred Qualifications: - Claims industry experience Required Skills: Workers Compensation Claims Adjudication, Claims Processing, Claims Documentation, Claims Coding, Medical Claims Processing, Client Communication, Office Administration, Empathy, Inclusion, Growth Benefits: Medical, Dental, Vision, 401K on day one, PTO, Disability and life insurance, Employee assistance, Flexible spending or health savings account, Other additional voluntary benefits