Remote Med-Only Claims Specialist

Sedgwick; Dubuque (IA); Hybrid; USD 41,000 - 57,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development opportunities

Benefits including medical, dental, 4-

Job summary

Sedgwick is hiring for a Claims Representative - Med Only with a multi-state jurisdiction and Home State licensing requirement. The role emphasizes analyzing Medical Only claims, adjudicating benefits, and maintaining service standards in a hybrid work setting.

It targets individuals who are driven, empathetic, and committed to client service. The position includes flexible scheduling, development opportunities, and a comprehensive benefits package.

Qualifications

• Education & Licensing: 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.
• Experience: 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 claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
• Negotiating settlement of claims within designated authority.
• Communicating claim activity and processing with the claimant and the client.
• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

Education

High School Diploma or GED

Bachelor's degree preferred

Professional certification applicable to line of business preferred

Job description

Sedgwick is hiring for a Claims Representative - Med Only with a multi-state jurisdiction and Home State licensing requirement. The role emphasizes analyzing Medical Only claims, adjudicating benefits, and maintaining service standards in a hybrid work setting.

It targets individuals who are driven, empathetic, and committed to client service. The position includes flexible scheduling, development opportunities, and a comprehensive benefits package.