Med-Only Claims Specialist (Hybrid/Remote)

Sedgwick; Moline (IL); Hybrid; USD 41,000 - 57,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401K on day one

Referral incentives

Flexible schedule

Career development

Job summary

Sedgwick is seeking a Claims Representative - Med Only to analyze Medical Only claims for clients, determine benefits due, and adjudicate claims within service standards. Hybrid schedule offered for those near Sedgwick offices; fully remote options possible for others.

The role emphasizes timely investigation, accuracy, and collaboration with clients while upholding Sedgwick's standards and licensing requirements across jurisdictions.

Qualifications

• Education & Licensing required: High School Diploma or GED; Bachelor's degree preferred.
• 2 years of claims management experience or equivalent.
• Jurisdiction knowledge: Multi State; Home State license required.

Responsibilities

• Analyzing and processing claims to determine exposure and resolve.
• Negotiating settlements within designated authority.
• Communicating claim activity with claimants and clients.
• Reporting claims to excess carriers and providing directions as needed.

Skills

Claims management

Analytical thinking

Customer service

Education

High School Diploma or GED

Bachelor's degree preferred

Job description

Sedgwick is seeking a Claims Representative - Med Only to analyze Medical Only claims for clients, determine benefits due, and adjudicate claims within service standards. Hybrid schedule offered for those near Sedgwick offices; fully remote options possible for others.

The role emphasizes timely investigation, accuracy, and collaboration with clients while upholding Sedgwick's standards and licensing requirements across jurisdictions.