Remote Medical Claims Specialist | Flexible Schedule

Sedgwick; Nashville (TN); Hybrid; USD 41,000 - 57,000; Full time

Benefits offered by this job

Flexible schedule

Referral program

Agile environment

Career development

Medical, dental, vision, 401K on day 1

Job summary

Sedgwick in the United States is seeking a Claims Representative for Medical Only with multi-state jurisdiction. This role analyzes Medical Only claims to determine benefits due while ensuring timely adjudication and client service.

Hybrid option: candidates near Sedgwick offices split time between office and home; fully remote possible for those outside 25-mile radius. No prior experience required; training provided.

Qualifications

• High School Diploma or GED required; Bachelor's degree from an accredited college or university preferred.
• 2 years of claims management experience or equivalent combination of education and experience required.

Responsibilities

• Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine 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.

Skills

Claims management

Analytical thinking

Education

High School Diploma

Bachelor's degree preferred

Job description

Sedgwick in the United States is seeking a Claims Representative for Medical Only with multi-state jurisdiction. This role analyzes Medical Only claims to determine benefits due while ensuring timely adjudication and client service.

Hybrid option: candidates near Sedgwick offices split time between office and home; fully remote possible for those outside 25-mile radius. No prior experience required; training provided.