Remote Medical Claims Specialist

Sedgwick; Saint Paul (MN); Hybrid; USD 41,000 - 57,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development opportunities

Medical benefits

Job summary

Sedgwick, the global leader in claims administration, is seeking a Claims Representative - Med Only for multi-state jurisdictions with hybrid work flexibility. You will analyze Medical Only claims to determine benefits due and adjudicate within client service standards.

Ideal candidates have a High School diploma or GED, plus 2 years of claims experience (bachelor’s preferred) and Home State licensing. Sedgwick offers professional growth, flexible schedules, and a comprehensive benefits package.

Qualifications

• Education and 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.

Responsibilities

• Analyzing and processing medical only claims to determine benefits due.
• Negotiating settlements within designated authority.
• Communicating claim activity with claimant and client.
• Reporting claims to excess carrier and handling directions professionally.

Skills

Claims management

Multistate jurisdiction knowledge

Communication skills

Education

High School Diploma or GED

Bachelor's degree preferred

Job description

Sedgwick, the global leader in claims administration, is seeking a Claims Representative - Med Only for multi-state jurisdictions with hybrid work flexibility. You will analyze Medical Only claims to determine benefits due and adjudicate within client service standards.

Ideal candidates have a High School diploma or GED, plus 2 years of claims experience (bachelor’s preferred) and Home State licensing. Sedgwick offers professional growth, flexible schedules, and a comprehensive benefits package.