Claims Specialist (Hybrid) 2025-1391 - Bethesda Maryland

Company: Managed Care Advisors
Location: Bethesda, Maryland
Posted On: 02/02/2025

Position Title: Claims Specialist (Hybrid) 2025-1391

Location: Bethesda, Maryland, United States

Job Category: Client Services

Job Type: Full Time

Description: Overview- Claims Specialist

Are you focused on details, skilled in claims management, and committed to customer service? Would you like to work in a professional organization that values intelligence, integrity and initiative? Would you like to be appreciated for your technical expertise?
As a Claims Specialist working on a Federal contract, you will be part of a collegial team that processes workers' compensation claims and communicates with all workers' compensation stakeholders, including the Agency. In this position, you are responsible for daily claims management of workers' compensation claims nationally. You are recognized as a general technical expert in the interpretation of complex or unusual policy coverages in area of expertise. Under general management direction, you work with broad authority on assignments requiring a degree of technical complexity and coordination.
Responsibilities

• Educating and assisting federal employees with claims under the Federal Employees' Compensation Act (FECA) regarding the claims process and status.
• Using the Employees' Compensation Operations and Management Portal (ECOMP) to monitor, review, and submit claims for workers' compensation benefits.
• Answering incoming telephone calls from federal employees and agency representatives.
• Facilitating the timely completion and submission of all required forms.
• Reviewing medical and administrative documentation for accuracy.
• Identifying and resolving claims documentation omissions or deficiencies.
• Answering questions with regard to the claims process.
• Calculate and verify Continuation of Pay and compensation amounts.
• Maintain high quality standards in accordance with our Quality Program
• Some evening or weekend coverage may be required.
  Qualifications
  • Bachelor's degree
  • A minimum of 2 years' experience in workers' compensation, lost time claim handling, claims adjuster/administration, case management, claims life cycle, and/or utilization review
  • An additional 4 years' experience may be substituted for a bachelor's degree
  • Federal Employees' Compensation Act (FECA) knowledge preferred
  • Strong computer skills (Microsoft Excel, Word, PowerPoint, and Outlook)
  • U.S. citizen
  • Able to obtain and maintain security clearance
    For a career path that is both challenging and rewarding, join Sedgwick Government Solution's talented team. Taking care of people is at the heart of everything we do. Our clients depend on our talented colleagues to take care of their most valuable assets-their employees, and their customers. At Sedgwick Government Solutions, caring counts -. Join our team of creative and caring people of all backgrounds and help us make a difference in the lives of others. Sedgwick Government Solutions 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 a specific location. 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. To be considered for this position, please submit a resume, and complete the application. The information provided above has been designed to indicate the general nature and level of work of the position. It is not a comprehensive inventory of all duties, responsibilities, and qualifications required. Important InformationSuccessful candidates will be required to undergo a financial and criminal background check and obtain and maintain confidential-level security clearance upon hire. We participate in the United States Federal Government E-Verify program to confirm the employment authorization of the employee upon hire. Search Firm Representatives Please be advised that Sedgwick Government Solutions (Government Solutions) is not seeking assistance or accepting unsolicited resumes from search firms for this employment opportunity. Regardless of past practice, a valid written agreement and task order must be in place before any resumes are submitted to Government Solutions. All resumes submitted by search firms to any employee at Government Solutions without a valid written agreement and task order in place will be deemed the sole property of Government Solutions and no fee will be paid in the event that person is hired by Government Solutions. Government Solutions strives to make our career site accessible to all users. If you need a disability-related accommodation for completing the application process, please contact Government Solutions regarding accommodations. Sedgwick Government Solutions is an Equal Opportunity and Affirmative Action Employer All qualified applicants will receive consideration for employment without regard to age, citizenship status, color, disability, marital status, national origin, race, religion, sex, sexual orientation, gender identity, veteran status, or any other classification protected by federal state or local laws as appropriate, or upon the protected status of the person's relatives, friends or associates. Sedgwick Government Solutions abides by the requirements of 41 CFR 60-741.5(a). This regulation prohibits discrimination against qualified individuals on the basis of disability and requires affirmative action by covered prime contractors and subcontractors to employ and advance in employment qualified individuals with disabilities. Sedgwick Government Solutions abides by the requirements of 41 CFR 60-300.5(a). This regulation prohibits discrimination against qualified protected veterans and requires affirmative action by covered prime contractors and subcontractors to employ and advance in employment qualified protected veterans. About SedgwickSedgwick Government Solutions is a fully owned subsidiary of Sedgwick. Sedgwick is a leading global provider of technology-enabled risk, benefits, and integrated business solutions. Taking care of people is at the heart of everything we do. Millions of people and organizations count on Sedgwick each year to take care of their needs when they face a major life event or something unexpected happens. The company provides a broad range of resources tailored to clients' specific needs in casualty, property, marine, benefits, and other lines. At Sedgwick, caring counts -; through the dedication and expertise of more than 27,000 colleagues across 65 countries, the company takes care of people and organizations by mitigating and reducing risks and losses, promoting health and productivity, protecting brand reputations, and containing costs that can impact the bottom line. www.sedgwick.com Privacy - Sedgwick Terms and Conditions - Sedgwick
    
    
    
    
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