Specialty Operations Coordinator

Specialty Operations Coordinator

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. Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance.

Primary Purpose: To analyze low- and mid-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:

• Adjusts medical-only claims and low- to mid-level lost-time workers compensation claims under close supervision.
• Supports other claims staff with larger or more complex claims as necessary.
• Processes workers compensation claims reviewing compensability, benefits due, and files necessary documentation with state agency.
• Communicates claim action/processing with appropriate parties including, but not limited to claimant, client, state agency, managed care organization and appropriate medical contact.
• Ensures claims files are properly documented, and claims coding is correct.
• Maintains professional client relationships.
• Coordinates actuarial/settlement issues impacting employers with rate and settlement departments.

Additional Functions and Responsibilities:

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

Qualifications:

Education & Licensing: High School Diploma and/or GED.

Experience: One (1) year of claims management experience or equivalent combination of education and experience required.

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

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.

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.