Remote Medical Claims Rep, Flexible Schedule

Sedgwick; Montgomery (AL); Hybrid; USD 41,000 - 57,000; Full time

Benefits offered by this job

Flexible schedule

Referral program

Agile environment

Career growth

Benefits on day one

Job summary

Sedgwick is seeking a Claims Representative - Med Only to analyze Medical Only claims for multi-state clients, determine benefits due, and adjudicate claims within service expectations.

Hybrid work is available with office proximity considerations; a High School Diploma is required (Bachelor's preferred), and 2 years of claims management experience is expected. Sedgwick offers career development, a referral program, and a comprehensive benefits package.

Qualifications

• Education & Licensing: High School Diploma or GED required; Bachelor's degree preferred.
• Professional certification as applicable to line of business preferred.
• Experience: 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 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.

Skills

Claims management

Communication

Education

High School Diploma or GED

Bachelor's degree preferred

Job description

Sedgwick is seeking a Claims Representative - Med Only to analyze Medical Only claims for multi-state clients, determine benefits due, and adjudicate claims within service expectations.

Hybrid work is available with office proximity considerations; a High School Diploma is required (Bachelor's preferred), and 2 years of claims management experience is expected. Sedgwick offers career development, a referral program, and a comprehensive benefits package.