Specialty Operations Coordinator

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work.

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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.

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

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

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.

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.