Hybrid Remote Medical Claims Specialist

Sedgwick; Topeka (KS); Hybrid; USD 41,000 - 57,000; Full time

Benefits offered by this job

Hybrid work schedule

Comprehensive benefits

401(K) on day one

Career development

Job summary

Sedgwick is hiring for a Claims Representative - Med Only with a multi-state jurisdiction and home-state licensing required, hybrid work options, and opportunities to grow within a global, employee-focused organization.

The role emphasizes analyzing Medical Only claims, determining benefits due, and maintaining adjudication within client service standards. Hybrid work, strong development, and extensive benefits are highlighted.

Qualifications

• Education & Licensing: High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred.
• Experience: 2 years of claims management experience or equivalent combination of education and experience required.
• Jurisdiction Knowledge: Multi State.
• Licensing: Home State Required.

Responsibilities

• Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
• Negotiating settlement of claims within designated authority.
• Communicating claim activity and processing with the claimant and the client.
• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

Education

High School Diploma or GED

Bachelor's degree

Job description

Sedgwick is hiring for a Claims Representative - Med Only with a multi-state jurisdiction and home-state licensing required, hybrid work options, and opportunities to grow within a global, employee-focused organization.

The role emphasizes analyzing Medical Only claims, determining benefits due, and maintaining adjudication within client service standards. Hybrid work, strong development, and extensive benefits are highlighted.