Note: The job is a remote job and is open to candidates in USA. Sedgwick is a recognized leader in the financial services and insurance sector, dedicated to supporting people facing unexpected challenges. They are seeking a Workers Compensation Consultant - Level 1 to analyze and manage less complex workers compensation claims, ensuring compliance and effective communication with stakeholders.
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)
Skills
- High school diploma required
- One (1) year of general office experience or equivalent combination of education and experience required
- Excellent oral and written communication skills
- PC literate, including Microsoft Office products
- Analytical and interpretive skills
- Strong organizational skills
- Good interpersonal skills
- Ability to work in a team environment
- Ability to meet or exceed Performance Competencies
- Claims industry experience preferred
- Paralegal expertise for handling claims, appeals, and compliance matters
- Strong knowledge of workers' compensation legislation and health & safety standards
- Proven ability to manage complex claims processes and collaborate with stakeholders
- Experience in HR leave programs, disability case management, and policy interpretation
Company Overview
Sedgwick is the world’s leading risk and claims administration partner, helping clients thrive by navigating the unexpected. It was founded in 1969, and is headquartered in Memphis, Tennessee, USA, with a workforce of 10001+ employees. Its website is http://www.sedgwick.com.