Remote Med-Only Claims Representative

Sedgwick; Sacramento (CA); Hybrid; USD 41,000 - 57,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401K on day one

Paid time off

Job summary

Sedgwick is seeking a Medical Only Claims Representative to analyze claims for multiple states and determine benefits due. The role supports timely adjudication and client service while leveraging Sedgwick’s global network and development opportunities.

Ideal candidates have a high school diploma or GED (Bachelor's preferred), 2 years of claims experience, and multi-state knowledge. Sedgwick offers comprehensive benefits and growth in a diverse, caring culture.

Qualifications

• High School Diploma or GED required.
• Bachelor’s degree from an accredited college or university preferred.
• Professional certification as applicable to line of business preferred.
• 2 years of claims management experience or equivalent combination of education and experience required.
• Jurisdiction Knowledge: Multi State
• Licensing: Home State Required

Responsibilities

• Analyzing and processing Medical Only claims to determine exposure and benefits due.
• Negotiating settlements within designated authority.
• Communicating claim activity with the claimant and client.
• Reporting claims to the excess carrier and responding to directions promptly.

Skills

Claims management experience

Multi-state jurisdiction knowledge

Home-state licensing

Education

High School Diploma or GED

Bachelor’s degree preferred

Professional certification (line of business)

Job description

Sedgwick is seeking a Medical Only Claims Representative to analyze claims for multiple states and determine benefits due. The role supports timely adjudication and client service while leveraging Sedgwick’s global network and development opportunities.

Ideal candidates have a high school diploma or GED (Bachelor's preferred), 2 years of claims experience, and multi-state knowledge. Sedgwick offers comprehensive benefits and growth in a diverse, caring culture.