Multi-State Claims Specialist - Hybrid/Remote

Sedgwick; Trenton (NJ); Hybrid; USD 41,000 - 57,000; Full time

Benefits offered by this job

Flexible schedule

Referral incentive

Career development

Comprehensive benefits

Job summary

Sedgwick is seeking a Claims Representative for Medical Only claims with a multi-state jurisdiction. This hybrid role requires handling claims from evaluation to settlement, coordinating with clients, and maintaining service standards.

Minimum education includes a high school diploma; a bachelor's degree and relevant certifications are preferred. Experienced candidates with 2 years of claims work are desired.

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 Knowledge: Multi State
• Licensing: Home State Required

Responsibilities

• Analyzing and processing Medical Only claims to determine benefits due and adjudication within service expectations and client requirements.
• Negotiating settlement of claims within designated authority.
• Communicating claim activity with the claimant and the client.
• Reporting claims to the excess carrier and responding to directions professionally and timely.

Education

High School Diploma or GED

Bachelor's degree

Professional certification as applicable to line of business

Job description

Sedgwick is seeking a Claims Representative for Medical Only claims with a multi-state jurisdiction. This hybrid role requires handling claims from evaluation to settlement, coordinating with clients, and maintaining service standards.

Minimum education includes a high school diploma; a bachelor's degree and relevant certifications are preferred. Experienced candidates with 2 years of claims work are desired.