Workers Compensation Claims Associate – Medical Only Claims, Claims Experience Preferred

Sedgwick

. Analyze reported lower-level workers compensation claims to determine benefits due and ensure ongoing adjudication within company standards and industry best practices .

Posted 10/27/2026full-timeDublin • Ohio • United StatesJuniorMid-Level💰 $22 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in processing and analyzing workers compensation claims, ensuring compliance with industry standards and effective communication with stakeholders. Proficient in medical terminology and maintaining accurate documentation while managing multiple priorities under pressure.

Highest-signal resume keywords

Workers Compensation Claims ProcessingMedical TerminologyClaims Industry ExperienceClear Thinking and Problem SolvingDeadline Management

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims AdjudicationClaims CodingReserve Accuracy MonitoringDocument FilingRoutine Payment ProcessingComputer Keyboarding

Soft Skills

Excellent JudgmentTroubleshootingDiscretionAbility to Handle Work-Related Stress

Certifications & Qualifications

High School DiplomaGED

Industry Keywords

Claims ExperienceJurisdictions: OH, IN, AL, NC, SC, GA

About the role

Key responsibilities & impact

Analyze reported lower-level workers compensation claims to determine benefits due and ensure ongoing adjudication within company standards and industry best practices
Adjust medical-only claims and minor lost-time workers compensation claims under close supervision
Support other claims representatives, examiners, and leads with larger or more complex claims
Process workers compensation claims, determining compensability and benefits due
Monitor reserve accuracy and file necessary documentation with state agency
Communicate claim action and processing with claimants, clients, and appropriate medical contacts
Ensure claim files are properly documented and claims coding is correct
Process routine payments, prescriptions, and status reports for lifetime medical claims and/or defined period medical claims
Maintain professional client relationships

Requirements

What you’ll need

High school diploma or GED required
Licenses as required
One (1) year of general office experience or equivalent combination of education and experience required
Claims industry experience preferred
Medical terminology background
Claims experience preferred
Jurisdictions: OH, IN, AL, NC, SC, GA
Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion
Ability to handle work-related stress and multiple priorities simultaneously
Ability to meet deadlines
Computer keyboarding
Hearing, vision and talking

Benefits

Comp & perks

A stable and consistent work environment in an office and/or virtual setting
Career development and promotional growth opportunities through increasing responsibilities
Diverse and comprehensive benefits package including medical, dental, vision, 401K and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits
Flexible work schedule
Referral incentive program
Opportunity to work in an agile environment