Workers Compensation Claims Examiner adjudicating complex customer claims at Sedgwick. Delivering solutions in a hybrid work environment to meet client expectations.
About the role
- Medical Claims Specialist ensuring claims processing accuracy and support for clients and members at Redirect Health. Collaborating with TPA leadership in a hybrid work environment.
Responsibilities
- Reviewing and validating claims to ensure all information is accurate and complete.
- Analyzing claims and product materials to process claims properly.
- Maintaining accurate and confidential claims records.
- Responding to provider inquiries and resolving claim-related issues.
- Identifying and correcting errors or missing information in claims.
- Building and maintaining professional relationships with members, clients, and providers.
Requirements
- 1 year of experience in medical claims processing, Required.
- Proficiency in Microsoft Word, Excel, and Electronic Medical Record (EMR) systems, Required.
- Ability to meet production and quality standards consistently.
- Solid knowledge of Microsoft Excel and Word.
- Professional, client-focused approach to colleagues and assignments.
Benefits
- FREE Healthcare Benefit for You and Your Family – No payroll deduction.
- Dental & Vision Insurance.
- Paid Sick & Vacation Time.
- Access to a 401K saving plan after 6 months.
Job title
Job type
Experience level
Salary
Degree requirement
No Education Requirement
Location requirements
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