Remote Medical Claims Specialist

Sedgwick; Boise (ID); Hybrid; USD 41,000 - 57,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development and promotional 성장

Job summary

Sedgwick is seeking a Claims Representative - Med Only to analyze Medical Only claims for our multi-state clients. This hybrid role allows 2 days in-office within 25 miles of a Sedgwick office or fully remote/work-from-home for others, with licensing: Home State Required.

You'll adjudicate benefits, negotiate settlements within authority, communicate with claimants and clients, and contribute to a caring, growth-focused culture with comprehensive benefits and development opportunities.

Qualifications

• High School Diploma or GED required; Bachelor's degree preferred.
• Professional certification relevant to line of business preferred.
• 2 years of claims management experience or equivalent.

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

Job description

Sedgwick is seeking a Claims Representative - Med Only to analyze Medical Only claims for our multi-state clients. This hybrid role allows 2 days in-office within 25 miles of a Sedgwick office or fully remote/work-from-home for others, with licensing: Home State Required.

You'll adjudicate benefits, negotiate settlements within authority, communicate with claimants and clients, and contribute to a caring, growth-focused culture with comprehensive benefits and development opportunities.