1 Claims Associate - Workers Compensation / Medical-Only (Wausau, WI) Job in Wausau, WI

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Claims Associate - Workers Compensation / Medical-Only (Wausau, WI)

Sedgwick

Wausau, WI | Full Time

$78k-92k (estimate)

0 Months Ago

Claims Associate - Workers Compensation / Medical-Only (Wausau, WI)

Sedgwick Wausau, WI

$78k-92k (estimate)

Full Time | Insurance 0 Months Ago

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Sedgwick is Hiring a Claims Associate - Workers Compensation / Medical-Only (Wausau, WI) Near Wausau, WI

The 'Apply with SEEK' option will be utilized for International applicants, mainly Australia.

Claims Associate - Workers Compensation / Medical-Only (Wausau, WI)

IF YOU CARE, THERE’S A PLACE FOR YOU HERE

For a career path that is both challenging and rewarding, join Sedgwick’s talented team of 27,000 colleagues around the globe. Sedgwick is a leading provider of technology-enabled risk, benefits and integrated business solutions. Taking care of people is at the heart of everything we do. Millions of people and organizations count on Sedgwick each year to take care of their needs when they face a major life event or something unexpected happens. Whether they have a workplace injury, suffer property or financial loss or damage from a natural or manmade disaster, are involved in an auto or other type of accident, or need time away from work for the birth of a child or another medical situation, we are here to provide compassionate care and expert guidance. Our clients depend on our talented colleagues to take care of their most valuable assets—their employees, their customers and their property. At Sedgwick, caring counts®. Join our team of creative and caring people of all backgrounds, and help us make a difference in the lives of others.

For more than 50 years, Sedgwick has been helping employers answer virtually every question there is about workers’ compensation. We have experience in nearly every type of industry and region and provide the industry’s broadest range of programs and services.

PRIMARY PURPOSE: To process low level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements with general supervision.

* Candidates must be commutable to the Wausau, WI office *

BENEFITS
Competitive hourly rates

Flexible work schedule

Referral Incentive Program

Internal career progression and development

Benefits eligibility and 401(k) with company match day 1

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

Processes low level workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.
Develops and coordinates low level workers compensation claims' action plans to resolution, return-to-work efforts, and approves claim payments.
Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract.
Administers subrogation of claims and negotiates settlements.
Communicates claim action with claimant and client.
Ensures claim files are properly documented and claims coding is correct.
May process low-level lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
Maintains professional client relationships.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

Performs other duties as assigned.
Supports the organization's quality program(s).
Travels as required.

QUALIFICATIONS

Education & Licensing

Bachelor's degree from an accredited college or university preferred.

Experience

Two (2) years of claims management experience or equivalent combination of education and experience or successful completion of Claims Representative training required.

Skills & Knowledge

Developing knowledge of regulations, offsets and deductions, disability duration, medical management practices and Social Security and Medicare application procedure as applicable to line of business
Excellent oral and written communication, including presentation 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 Service Expectations

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

NOTE: Credit security clearance, confirmed via a background credit check, is required for this position.

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. #LI-Onsite

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

Job Summary

JOB TYPE

Full Time

INDUSTRY

Insurance

SALARY

$78k-92k (estimate)

POST DATE

04/10/2023

EXPIRATION DATE

05/10/2024

WEBSITE

sedgwick.com

HEADQUARTERS

PORTLAND, OR

SIZE

15,000 - 50,000

FOUNDED

1969

CEO

DAVID A NORTH J

REVENUE

$3B - $5B

INDUSTRY

Insurance

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About Sedgwick

Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. The company provides a broad range of resources tailored to our clients specific needs in casualty, property, marine, benefits and other lines. At Sedgwick, caring counts; through the dedication and expertise of nearly 27,000 colleagues across 65 countries, the company takes care of people and organizations by mitigating and reducing risks and losses, promoting health and productivity, protecting brand reputations, and containing costs that can impact the bottom line. Sedgwicks majorit...y shareholder is The Carlyle Group; Stone Point Capital LLC, Caisse de dpt et placement du Qubec (CDPQ), Onex and other management investors are minority shareholders. For more, see sedgwick.com. More
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