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.
Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies
Certified as a Great Place to Work®
Fortune Best Workplaces in Financial Services & Insurance
Workers Compensation Consultant - Level 1- Must be located in BCPRIMARY PURPOSE: To analyze reported less complex 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
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.
ADDITIONAL FUNCTIONS AND RESPONSIBILITIES
Performs other duties as assigned.
Supports the organization's quality program(s).
QUALIFICATIONS
Education & Licensing
High school diploma required.
Experience
One (1) year of general office experience or equivalent combination of education and experience required. Claims industry experience preferred.
Skills & Knowledge
Skills & Knowledge
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
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
Where applicable, Sedgwick uses artificial intelligence tools to assist in the screening, assessment, or selection of candidates. These tools are subject to periodic review.
We are committed to inclusive, barrier-free recruitment and selection processes. If contacted for an employment opportunity, please advise Colleague Resources if you require accommodation.
Sedgwick is an Equal Opportunity Employer
Sedgwick is an Equal Opportunity Employer.
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Sedgwick retains the discretion to add or to change the duties of the position at any time.