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Sedgwick Claims Management Services
Telecommuter, United States
(on-site)
Posted
1 day ago
Sedgwick Claims Management Services
Telecommuter, United States
(on-site)
Job Type
Full-Time
Unemployment Specialist
The insights provided are generated by AI and may contain inaccuracies. Please independently verify any critical information before relying on it.
Unemployment Specialist
The insights provided are generated by AI and may contain inaccuracies. Please independently verify any critical information before relying on it.
Description
By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies
Certified as a Great Place to Work®
Fortune Best Workplaces in Financial Services & Insurance
Unemployment Specialist
This position will have a heavy focus on processing unemployment charges for Sedgwick clients.
PRIMARY PURPOSE : To analyze complex or technically difficult unemployment claims to determine benefits due; and to ensure ongoing adjudication of claims within company standards and industry best practices or client specific requirements.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
ARE YOU AN IDEAL CANDIDATE? We are looking for enthusiastic candidates who thrive in a collaborative environment, who are driven to deliver great work.
- Analyzes and processes complex or technically difficult claims by investigating and gathering information to assist employer in determining their position on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
- Works to move claim towards appropriate claim closure which may include appeal to hearing or Board of Review.
- Represents the company at administrative unemployment compensation hearings as needed.
- Monitors and reviews benefits due and payment calculations ensuring accuracy.
- Prepares necessary state filings within statutory limits.
- Follows best practice standards in contested claims.
- Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
- Communicates claim action/processing with appropriate parties including, but not limited to: claimant, client, state agency, managed care organization and appropriate medical contact.
- Ensures claims files are properly documented and claims coding is correct.
- Maintains professional client relationships.
- Assesses policy level status of clients; works in coordination with clients' service expectations and assigned service personnel.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
- Performs other duties as assigned.
- Supports the organization's quality program(s).
QUALIFICATIONS
Education & Licensing
Bachelor's degree from an accredited college or university preferred. Licenses as required. Professional certification as applicable to line-of-business preferred.
Experience
Three (3) years claims management experience or equivalent combination of education and experience required.
Skills & Knowledge
- In-depth line-of-business knowledge of appropriate insurance principles and laws, recoveries offsets and deductions, and cost containment principles
- Excellent oral and written communication skills, 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.
TAKING CARE OF YOU BY
- We offer a diverse and comprehensive benefits package including:
- Three Medical, and two dental plans to choose from.
- Tuition reimbursement eligible.
- 401K plan that matches 50% on every $ you put in up to the first 6% you save.
- 4 weeks PTO your first full year.
NEXT STEPS
If your application is selected to advance to the next round, a recruiter will be in touch.
As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $50,000 - $58,000. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.
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.
If you're excited about this role but your experience doesn't 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.
Requisition #: R67444
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Job ID: 80936989

Sedgwick Claims Management Services
Insurance
Tennessee
,
United States
Sedgwick Claims Management Services, Inc. (Sedgwick CMS) is the leader in innovative claims and productivity management solutions to major employers. Sedgwick CMS provides cost-effective claims administration, managed care, program management and related services through the expertise of 6,400 colleagues in more than one hundred and fifty offices and service locations in the U.S. and Canada.
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