Job Overview
Location
US Telecommuter
Job Type
Full-time
Category
HR & Recruiting
Date Posted
May 13, 2026
Full Job Description
đź“‹ Description
- • As an RN Medicare Compliance-Proactive Reduction Outreach specialist at Sedgwick, you will play a critical role in ensuring accurate and compliant Medicare Set-Aside allocations by conducting clinical assessments and provider outreach, directly supporting clients navigating complex workers’ compensation and liability settlements.
- • Day to day, you will contact providers and attorneys to obtain necessary documentation, review and analyze medical records for accuracy and completeness, develop customized correspondence to clarify case details, and measure the financial and clinical outcomes of your interventions while maintaining strict adherence to regulatory and ethical standards.
- • You will join Sedgwick’s dedicated team of 33,000 colleagues committed to a caring culture, recognized by Newsweek as one of America’s Greatest Workplaces, certified as a Great Place to Work®, and honored as a Fortune Best Workplace in Financial Services & Insurance, where your contributions support people facing unexpected life events.
- • In this role, you will deepen your expertise in Medicare compliance, clinical documentation analysis, and healthcare coordination, while strengthening your communication, organizational, and analytical skills in a collaborative, mission-driven environment that values professional growth and work-life balance.
🎯 Requirements
- • Active unrestricted RN license issued in a state or territory of the United States
- • Bachelor’s degree from an accredited college or university preferred
- • Four (4) years of related experience or equivalent combination of education and experience
- • Excellent oral and written communication skills, including presentation skills
- • PC literacy, including proficiency with Microsoft Office products
- • Strong analytical and interpretive skills, with ability to create comprehensive, accurate written reports
🏖️ Benefits
- • Three medical and two dental plans to choose from
- • Tuition reimbursement eligibility
- • 401K plan with 50% company match on the first 6% of employee contributions
- • Four weeks of PTO in the first full year of employment
- • Comprehensive benefits package including vision, disability, life insurance, employee assistance, and flexible spending or health savings accounts
Skills & Technologies
About Sedgwick Claims Management Services, Inc.
Sedgwick is a global provider of technology-enabled risk, benefits and integrated business solutions, primarily handling insurance claims, managed care, absence and disability, and productivity management for employers, carriers, and administrators. The company processes millions of claims annually across workers' compensation, property, casualty, disability, and other lines, leveraging analytics and digital platforms to improve outcomes, reduce costs, and enhance customer and employee experiences.
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