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Claims Management Specialist

2 months ago

Columbus, Ohio, United States Sedgwick Full time

About the Role

Sedgwick is seeking a highly skilled Claims Management Specialist to join our team. As an OSS Coordinator, you will play a critical role in supporting the claims management system for our local office or multiple office locations.

Key Responsibilities

  • Complete examiner update reports, claim adjustments, provider requests, and operational expense check requests.
  • Queue claims for Managed Care; transfer payment allocations; and run manual pre-pay and balances as requested.
  • Create and maintain internal and external logins and the applicable security access for the company's claims management systems.
  • Coordinate with the company's internal audit group to ensure security access is defined and implemented according to established policies and procedures.
  • Communicate and collaborate with other internal departments to support the security needs of end-users.
  • Research and gather data as needed for auditing, special projects, or returned checks.
  • Provide telephone support to end-users.

Additional Responsibilities

  • Perform other duties as assigned.
  • Support the organization's quality program(s).

Requirements

  • High School diploma or GED required. Associate degree preferred.
  • Two (2) years of claims management or insurance experience or equivalent combination of education and experience required.
  • 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 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.

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

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