Remote Medical Claims Specialist

Sedgwick; Madison (WI); Hybrid; USD 41,000 - 57,000; Full time

Benefits offered by this job

Flexible schedule

Referral program

Career development

Benefits including 401k

Job summary

Sedgwick is seeking a Claims Representative - Med Only to analyze Medical Only claims for multiple clients across states. This role emphasizes timely adjudication, accurate benefits determination, and adherence to client service requirements.

Hybrid work arrangement is available: 2 days in office and 3 days remote for local candidates; fully remote/work-from-home may be considered for others. Requires no prior experience; strong training and career development are offered.

Qualifications

• High School Diploma or GED required.
• Bachelor's degree from an accredited college or university preferred.
• Professional certification related to the line of business preferred.

Responsibilities

• Analyzing and processing claims to determine exposure and resolution.
• Negotiating settlements within designated authority.
• Communicating claim activity with the claimant and the client.
• Reporting claims to the excess carrier and responding to 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 multiple clients across states. This role emphasizes timely adjudication, accurate benefits determination, and adherence to client service requirements.

Hybrid work arrangement is available: 2 days in office and 3 days remote for local candidates; fully remote/work-from-home may be considered for others. Requires no prior experience; strong training and career development are offered.