Claims Technician

Sedgwick Claims Management Services, Inc. Orange , CA 92856

Posted 2 months ago

Claims Technician

CLAIM YOUR FUTURE AS A GREAT PERFORMER!

Providing both satisfying and challenging work along with a highly professional and friendly work atmosphere, Sedgwick has a strong commitment to its colleagues and its clients. If you are seeking a place where you can do great things for those whose lives you touch while maximizing your own career possibilities, Sedgwick is the place for you. As the largest and most innovative Third Party Administrator in the claims industry and the first and only TPA to receive both recognition as the Best TPA in America and the coveted Employer of Choice designation, we invite you to come be a part of our team and, "Claim Your Future."

PRIMARY PURPOSE: To provide technical claim support to the claims staff and customer service to claimants, clients and vendors. May perform some administrative duties as required.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

  • Calculates average weekly wage and compensation rate; submits to examiner for approval.

  • Calculates and schedules weekly Total Temporary Disability/Total Permanent Disability (TTD/TPD) indemnity payments; submits to examiner for approval.

  • Calculates and verifies court ordered payments and issues timely; submits to examiner for approval.

  • Calculates cost of living adjustments (COLA) per state requirements; submits to examiner for approval.

  • Handles utilization review, vendor, claimant and client calls for the claims examiners.

  • Submits approved bills to the bill review vendor for payment.

  • Calculates and processes out-of-pocket expenses and manual bills for vendors and claimants.

  • Performs administrative duties, such as filing, copying, etc., as required.

ADDITIONAL FUNCTIONS and RESPONSIILITIES

  • Performs other duties as assigned.

  • Supports the organization's quality program(s).

QUALIFICATIONS

Education & Licensing

High school diploma or GED.

Experience

One (1) year of clerical or customer service experience or equivalent combination of experience and education required.

Skills & Knowledge

  • Excellent oral and written communication, including presentation skills

  • PC literate, including Microsoft Office products

  • Strong organizational skills

  • Excellent 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 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.

The statements contained in this document are inteneded to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constiture a comprehensive list of functions, duties, or local variances. Management retains the disscretion to add or to change the duties of the position at any time.

Sedgwick is an Equal Opportunity Employer

and a

Drug-Free Workplace

#LI-TS


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Claims Technician

Sedgwick Claims Management Services, Inc.