Remote Medical Claims Specialist

Sedgwick; Honolulu (HI); Hybrid; USD 41,000 - 57,000; Full time

Benefits offered by this job

Referral incentive program

Flexible schedule

Career development

Benefits package

Job summary

Sedgwick is hiring for a Claims Representative - Med Only with a multi-state jurisdiction. The hybrid role may require travel and offers a comprehensive benefits package and opportunities for career growth.

The position emphasizes analyzing Medical Only claims and delivering timely adjudication in line with client requirements. Ideal candidates have at least 2 years of claims experience, a high school diploma (Bachelor's preferred), and Home State licensing.

Qualifications

• 2 years of claims management experience or equivalent combination of education and experience required.
• Licensing: Home State Required with multi-state jurisdiction knowledge.
• Strong communication and negotiation skills with attention to client service requirements.

Responsibilities

• Analyze medical only claims and determine benefits due.
• Negotiate settlements within designated authority.
• Communicate claim activity with claimants and clients.
• Report claims to excess carriers and respond to directions timely.

Skills

Claims management

Negotiation

Communication

Education

High School Diploma or GED

Bachelor's degree preferred

Job description

Sedgwick is hiring for a Claims Representative - Med Only with a multi-state jurisdiction. The hybrid role may require travel and offers a comprehensive benefits package and opportunities for career growth.

The position emphasizes analyzing Medical Only claims and delivering timely adjudication in line with client requirements. Ideal candidates have at least 2 years of claims experience, a high school diploma (Bachelor's preferred), and Home State licensing.