Medical Claims Specialist - Multi-State (Hybrid/Remote)

Sedgwick; Helena (MT); Hybrid; USD 41,000 - 57,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development opportunities

401K on day one

Medical, dental, vision

Job summary

Sedgwick is hiring a Claims Representative - Med Only to analyze Medical Only claims for multiple states with a hybrid work model. The role requires no prior experience but prefers relevant education and licenses, offering growth and development within a global company.

Hybrid arrangement: 2 days in office, 3 days remote for nearby candidates; fully remote considered for others, with strong benefits and ongoing professional development.

Qualifications

• High School Diploma or GED required; Bachelor's degree preferred.
• 2 years of claims management experience or equivalent combination of education and experience.
• Jurisdiction: Multi State; Home State licensing required.

Responsibilities

• Analyze Medical Only claims to determine benefits due and adjudicate timely.
• Negotiate settlements within designated authority.
• Communicate claim activity with claimant and client.
• Report claims to excess carrier and handle directions professionally.

Skills

Claims management

Education

Bachelor's degree

High School Diploma or GED

Professional certification (as applicable)

Job description

Sedgwick is hiring a Claims Representative - Med Only to analyze Medical Only claims for multiple states with a hybrid work model. The role requires no prior experience but prefers relevant education and licenses, offering growth and development within a global company.

Hybrid arrangement: 2 days in office, 3 days remote for nearby candidates; fully remote considered for others, with strong benefits and ongoing professional development.