Medical-Only Claims Specialist — Hybrid

Sedgwick; Marlton (NJ); Hybrid; USD 29,000 - 42,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Agile environment

Career development

Medical, dental, vision, 401K on day 1

Job summary

Sedgwick in Marlton, NJ is seeking a dedicated Medical Only Claims Associate to analyze lower-level workers' compensation claims and determine benefits due within company standards and industry best practices.

The role offers a hybrid schedule (2 days in-office) with remote option if outside commuting distance, opportunities for career development, a supportive culture, and a comprehensive benefits package including medical, dental, vision, 401(k) and more.

Qualifications

• High school diploma or GED required.
• One (1) year of general office experience or equivalent combination of education and experience required.
• Claims industry experience preferred.

Responsibilities

• Adjusts medical-only claims and minor lost-time workers compensation claims under close supervision.
• Supports other claims representatives, examiners and leads with larger or more complex claims as necessary.
• Processes workers compensation claims determining compensability and benefits due; monitors reserve accuracy, and files necessary documentation with state agency.
• Communicates claim action/processing with claimant, client and appropriate medical contact.
• Ensures claim files are properly documented and claims coding is correct.
• May process routine payments and prescriptions and status reports for lifetime medical claims and/or defined period medical claims.
• Maintains professional client relationships.

Education

High school diploma or GED

Job description

Sedgwick in Marlton, NJ is seeking a dedicated Medical Only Claims Associate to analyze lower-level workers' compensation claims and determine benefits due within company standards and industry best practices.

The role offers a hybrid schedule (2 days in-office) with remote option if outside commuting distance, opportunities for career development, a supportive culture, and a comprehensive benefits package including medical, dental, vision, 401(k) and more.