Status: Full-time position
Location: Albuquerque, NM
Job Summary: Providing both satisfying and challenging work along with a highly professional and friendly work atmosphere, Sedgwick Claims Management Services, Inc. has a strong commitment to its colleagues and its clients. If you are seeking place where you can do great things for those whose lives you touch while maximizing your own career possibilities, Sedgwick CMS 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."
Qualifications: Education & Licensing
Baccalaureate degree from an accredited college or university required.
No experience required. Prior claims experience preferred. Equivalent experience may be substituted for the required degree.
Skills & Knowledge
Excellent oral and written communication
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
Duties: Adjusts medical-only claims and minor lost-time workers compensation claims under close supervision.
Handles low and mid-level liability and/or physical damage claims or disability claims of minimal disability duration under close supervision.
Supports other claims examiners and claims supervisors with larger or more complex claims as necessary.
Processes general liability claims by gathering information to determine liability exposure, assigns reserve values to claims, making claims payments as necessary and settling claims up to the designated authority level.
Processes workers compensation claims determining compensability and benefits due, monitors reserve accuracy and files necessary documentation with state agency.
Processes assigned disability claims and determines benefits due pursuant to the disability plan or client contract, and makes timely claims payments.
Communicates claim action/processing with claimant and client.
Ensures claim files are properly documented and claims coding is correct.
Maintains professional client relationships.