Remote Medical-Only Claims Specialist

Sedgwick; Harrisburg (Dauphin County); Hybrid; USD 41,000 - 57,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development opportunities

Medical, dental, vision, 401K on day 1

Job summary

Sedgwick seeks a Claims Representative - Med Only to analyze Medical Only claims for multiple states. Hybrid work options apply; home-state licensing is required. The role emphasizes timely adjudication, client service, and coordination with carriers within authority limits.

A strong emphasis on empathy, accountability, and collaboration supports our caring culture. Candidates should have at least 2 years in claims management, a multi-state knowledge base, and a high school diploma or higher.

Qualifications

• 2 years of claims management experience or equivalent combination of education and experience required.
• Jurisdiction knowledge: Multi State
• Licensing: Home State Required

Responsibilities

• Analyzing and processing claims through action plans to determine exposure and timely resolution.
• Negotiating settlement within designated authority.
• Communicating claim activity with the claimant and the client.
• Reporting claims to the excess carrier and responding to directions professionally and timely.

Skills

Empathy

Accountability

Collaboration

Growth

Inclusion

Education

High School Diploma or GED

Bachelor's degree preferred

Professional certification preferred

Job description

Sedgwick seeks a Claims Representative - Med Only to analyze Medical Only claims for multiple states. Hybrid work options apply; home-state licensing is required. The role emphasizes timely adjudication, client service, and coordination with carriers within authority limits.

A strong emphasis on empathy, accountability, and collaboration supports our caring culture. Candidates should have at least 2 years in claims management, a multi-state knowledge base, and a high school diploma or higher.