Claims Operations Associate

7 days 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 - Claims Support, you will play a critical role in supporting and maintaining 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.

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.

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