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 National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Specialty Operations Coordinator

• 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.

• ARE YOU AN IDEAL CANDIDATE?

• We are looking for enthusiastic candidates who thrive in a collaborative environment, who are driven to deliver great work.

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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.

• QUALIFICATIONS

• Education & Licensing
• High School diploma or GED required. Licenses as required.
• 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. + Supports the organization's quality program(s). + Performs other duties as assigned.

• WORK ENVIRONMENT

• When applicable and appropriate, consideration will be given to reasonable accommodations.

• TAKING CARE OF YOU BY

• + We offer a diverse and comprehensive benefits package including: + Three Medical, and two dental plans to choose from. + Tuition reimbursement eligible. + 401K plan that matches 50% on every $ you put in up to the first 6% you save. + 4 weeks PTO your first full year.

• NEXT STEPS

• If your application is selected to advance to the next round, a recruiter will be in touch.

_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 $16.00 - 21.00/hr. 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.
• Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected.

The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see

• sedgwick.com

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