Claims Associate - Workers Compensation | Med Only | Jurisdiction: NY and PA | Licensing: NY Li[...]

Overview By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work‑life balance. Here, there’s no limit to what you can achieve. Position Summary Claims Associate – Workers Compensation (Medical Only) – Jurisdiction: NY and PA. Licensing: NY preferred. Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands? Job Highlights Apply your knowledge and experience to adjudicate complex customer claims in an energetic culture. Deliver innovative customer‑facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations. Be part of a rapidly growing, industry‑leading global company known for its excellence and customer service. Leverage Sedgwick’s broad, global network of experts to both learn from and share insights. Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career. Enjoy flexibility and autonomy in your daily work, your location, and your career path. Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs. Ideal Candidate We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion. Primary Purpose To analyze reported lower‑level workers compensation claims to determine benefits due; and to ensure ongoing adjudication of claims within company standards and industry best practices. Essential Functions and Responsibilities Adjust medical‑only claims and minor lost‑time workers compensation claims under close supervision. Support other claims representatives, examiners and leads with larger or more complex claims as necessary. Process workers compensation claims determining compensability and benefits due; monitor reserve accuracy, and file necessary documentation with state agency. Communicate claim action/processing with claimant, client and appropriate medical contact. Ensure 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. Maintain professional client relationships. Qualifications Education & Licensing: High school diploma or GED required. Licenses as required. Experience: One (1) year of general office experience or equivalent combination of education and experience required. Claims industry experience preferred. Jurisdiction: NY and PA Licensing: NY preferred Taking Care of You Flexible work schedule. Referral incentive program. Career development and promotional growth opportunities. A diverse and comprehensive benefits offering including medical, dental, vision, 401(k) on day one. Work Environment When applicable and appropriate, consideration will be given to reasonable accommodations. Mental: 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; and ability to meet deadlines. Physical: Computer keyboarding, travel as required. Auditory/Visual: Hearing, vision and talking. As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is ($18.06 - $22.00 USD Hourly). A comprehensive benefits package is offered 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. Sedgwick is an Equal Opportunity Employer and a Drug‑Free Workplace. If you’re excited about this role but your experience doesn’t align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles. #J-18808-Ljbffr Sedgwick