Our goal is to make Sedgwick CMS a place where great people can do great things for our clients. This commitment is evidenced by our colleague development program and supported by our multi-dimensional learning resources.
We invest in the education of our colleagues by providing training and learning resources that focus on our culture, procedures, systems and performance expectations. We evaluate the educational needs of our colleagues through performance discussions and evaluations. These needs are filled either through Sedgwick CMS University and through industry certification programs and other external educational resources . Sedgwick CMS University curriculum offerings take colleagues from orientation to technical training to supervisory and managerial development. Through Sedgwick CMS University, we provide our colleagues continuous development of professional skills and the ability to deliver quality service to our clients.
We offer a required colleague orientation program that allows us to verify and document the training provided to new colleagues. This program is called Personal Responsibility in Developing Excellence (PRIDE) and is the first component of our comprehensive career development process. This program introduces and orients new and transitioning colleagues to our company and to their new position. PRIDE will take colleagues through the first 90 days of their new position. Objectives of this program focus on providing colleagues an increased awareness of who we are, where we are going, and how they can help us get there.
Career path options are identified through an ongoing process of discussion and collaboration between colleagues and their managers. On an ongoing basis, our managers counsel colleagues regarding their career path, new opportunities, and additional training and development requirements to help them reach their individual goals.
PRIMARY PURPOSE: To process claims and determine benefits due pursuant to a disability plan; to make timely payments and adjustments for workers compensation, Social Security Disability Income (SSDI), and other disability offsets; and to ensure the ongoing processing of claims.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
- Makes claim determinations to approve non-complex disability claims or makes a recommendation to team lead to deny claims based on the disability plan.
- Determines benefits due, makes timely claims payments and adjustments for workers compensation, Social Security Disability Income (SSDI), and other disability offsets.
- Informs claimants of documentation required to process claims, required time frames, payment information and claims status either by phone, written correspondence and/or claims system.
- Refers cases as appropriate to team lead; maintains professional client relationships.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
- Performs other duties as assigned.
- Supports the organization's quality program(s).
Education & Licensing
High school diploma or GED required. College preferred.
Two (2) years of related experience or equivalent combination of education and experience required to include one (1) year general office or customer service experience. One (1) year of benefits or claims management experience preferred.
Skills & Knowledge
- Excellent oral and written communication
- PC literate, including Microsoft Office products
- Analytical and interpretive skills
- Strong organizational skills
- Ability to work in a team environment
- Ability to meet or exceed Performance Competencies
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 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.
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Social Security Disability Insurance
Paid Sick Leave
|Years of Experience||1-2 Years|