Remote Claims Representative – Med Only (Multi-State)

Sedgwick; Cheyenne (WY); Hybrid; USD 41,000 - 57,000; Full time

Benefits offered by this job

Flexible schedule

Referral program

Agile environment

Career development and growth

Benefits on day one

Job summary

Sedgwick is hiring for a Claims Representative - Med Only. The role analyzes Medical Only claims for multiple clients, determines benefits due, and ensures timely adjudication within service standards.

Hybrid schedule supports both in-office and remote work choices within the 25-mile and beyond radius. The ideal candidate has a high school diploma (Bachelor's preferred), two years in claims management, and relevant certifications.

Qualifications

• High School Diploma or GED required.
• Bachelor's degree preferred.
• Professional certification as applicable to line of business preferred.
• 2 years of claims management experience or equivalent combination of education and experience required.

Responsibilities

• Analyzing and processing medical-only claims to determine benefits due and ensure adjudication within service expectations.
• Negotiating settlements within designated authority.
• Communicating claim activity with claimants and clients.
• Reporting claims to excess carriers and responding to directions professionally.

Skills

Claims management

Communication

Education

High School Diploma or GED

Bachelor's degree

Professional certification

Job description

Sedgwick is hiring for a Claims Representative - Med Only. The role analyzes Medical Only claims for multiple clients, determines benefits due, and ensures timely adjudication within service standards.

Hybrid schedule supports both in-office and remote work choices within the 25-mile and beyond radius. The ideal candidate has a high school diploma (Bachelor's preferred), two years in claims management, and relevant certifications.