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Claims Associate Liability Blue Ash OH
PRIMARY PURPOSE: To analyze reported lowerlevel level general liability claims to determine benefits due; and to ensure ongoing adjudication of claims within company standards and industry best practices.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Handles lowerlevel liability and/or physical damage claims under close supervision.
Supports other claims representatives examiners and leads with larger or more complex claims as necessary.
Processes general liability claims determining compensability and benefits due; monitors reserve accuracy and files necessary documentation with state agency.
Communicates claim action/processing with claimant client and appropriate medical contact.
Ensures claim files are properly documented and claims coding is correct.
May process routine payments and prescriptions and status reports for lifetime medical claims and/or defined period medical claims.
Maintains professional client relationships.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
Performs other duties as assigned.
Supports the organizations quality program(s).
QUALIFICATION
Education & Licensing
High school diploma or GED required. Licenses as required.
Experience
One 1 year of general office experience or equivalent combination of education and experience required. Claims industry experience preferred.
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 workrelated stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
Physical: Computer keyboarding travel as required
Auditory/Visual: Hearing vision and talking
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Sedgwickis an Equal Opportunity Employer and a DrugFree Workplace.
If youre excited about this role but your experience doesnt 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.