Remote Medical Claims Specialist | Flexible Schedule

Sedgwick; Juneau (AK); Hybrid; USD 41,000 - 57,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development opportunities

Benefits package on day one

Job summary

Sedgwick is hiring a Claims Representative - Med Only to analyze Medical Only claims for multiple states. The role requires evaluating benefits, timing adjudication to client service requirements, and working in a hybrid environment.

Ideal candidates have 2 years of claims management experience, a high school diploma or GED, and may hold a bachelor’s degree. Sedgwick offers a broad benefits package and growth opportunities.

Qualifications

• High school diploma or GED required; bachelor’s degree preferred.
• 2 years of claims management experience or equivalent.
• Jurisdiction knowledge: multi-state; licensing: home state required.

Responsibilities

• Analyze and process Medical Only claims to determine benefits due.
• Negotiate settlements within designated authority.
• Communicate claim activity with claimants and clients.
• Report claims to the excess carrier and respond to directions.

Skills

Claims processing

Negotiation

Client communication

Multitasking

Education

High School Diploma or GED

Bachelor's degree preferred

Job description

Sedgwick is hiring a Claims Representative - Med Only to analyze Medical Only claims for multiple states. The role requires evaluating benefits, timing adjudication to client service requirements, and working in a hybrid environment.

Ideal candidates have 2 years of claims management experience, a high school diploma or GED, and may hold a bachelor’s degree. Sedgwick offers a broad benefits package and growth opportunities.