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Medical Claims Associate Jobs in Arizona (NOW HIRING)

Proactively investigating claims * Applying policy coverage * Accurately documenting claim files ... All medical plans provide 100% coverage for in-network preventative care, AND you and your family ...

Proactively investigating claims * Applying policy coverage * Accurately documenting claim files ... All medical plans provide 100% coverage for in-network preventative care, AND you and your family ...

Proactively investigating claims * Applying policy coverage * Accurately documenting claim files ... All medical plans provide 100% coverage for in-network preventative care, AND you and your family ...

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Medical Claims Associate information

What are some common challenges faced by medical claims associates, and how can they be effectively managed?

Medical Claims Associates often encounter challenges such as managing high volumes of claims, navigating complex insurance policies, and ensuring accuracy under tight deadlines. To address these, it's important to develop strong organizational skills, keep up-to-date with the latest policy changes, and utilize available claims processing software efficiently. Additionally, collaborating closely with healthcare providers and insurance representatives can help clarify discrepancies and resolve issues more quickly, making teamwork and communication key assets in this role.

What does a medical claims associate do?

A Medical Claims Associate is responsible for reviewing, processing, and adjudicating medical insurance claims submitted by healthcare providers or policyholders. They verify the accuracy of claims, ensure compliance with insurance policies, and determine the appropriate payment or denial based on guidelines. The role involves communication with healthcare providers, patients, and insurance companies to resolve discrepancies or gather additional information. Medical Claims Associates play a crucial part in ensuring that claims are handled efficiently and accurately, contributing to the smooth operation of healthcare reimbursement processes.

What is the difference between Medical Claims Associate vs Medical Billing Specialist?

AspectMedical Claims AssociateMedical Billing Specialist
CredentialsHigh school diploma; certification often preferredHigh school diploma; certification often preferred
Work EnvironmentHealthcare offices, insurance companiesHealthcare offices, billing companies
Primary ResponsibilitiesReview and process insurance claims, ensure accuracyGenerate bills, submit claims, follow up on payments
Industry UsageInsurance companies, healthcare providersHealthcare providers, billing services

While both roles involve working with healthcare payments, a Medical Claims Associate primarily reviews and processes insurance claims to ensure accuracy and compliance. In contrast, a Medical Billing Specialist focuses on generating bills, submitting claims, and managing payment collections. Both roles require similar credentials and often work in healthcare or insurance settings, but their core functions differ in the claims review versus billing process.

What are the key skills and qualifications needed to thrive as a medical claims associate, and why are they important?

To thrive as a Medical Claims Associate, you need strong knowledge of medical terminology, health insurance policies, and claims processing, often supported by a high school diploma or associate degree. Familiarity with claims management software, coding systems like ICD-10 or CPT, and basic office applications is essential. Attention to detail, problem-solving, and effective communication are vital soft skills for accuracy and client interactions. These skills ensure timely, accurate claims processing and help prevent errors or fraud, supporting efficient healthcare operations.
What are the most commonly searched types of Medical Claims jobs in Arizona? The most popular types of Medical Claims jobs in Arizona are:
What cities in Arizona are hiring for Medical Claims Associate jobs? Cities in Arizona with the most Medical Claims Associate job openings:
Infographic showing various Medical Claims Associate job openings in Arizona as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 14% Part Time, and 5% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution.

Claims Associate - Workers Compensation

Sedgwick

Flagstaff, AZ • On-site

$20 - $24/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 2 days ago

New


Sedgwick rating

7.6

Company rating: 7.6 out of 10

Based on 321 frontline employees who took The Breakroom Quiz

209th of 304 rated insurance


Job description

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.

Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies

Certified as a Great Place to Work®

Fortune Best Workplaces in Financial Services & Insurance

Claims Associate - Workers Compensation

Are you looking for an impactful job requiring no prior experience that offers an opportunity to develop a professional career?

  • Career development and promotional growth opportunities through increasing responsibilities

  • A diverse and comprehensive benefits package to take care of your mental, physical, financial and professional needs

PRIMARY PURPOSE OF THE ROLE: To be oriented and trained as new industry professional with the ability to analyze workers compensation claims and determine benefits due.

ARE YOU AN IDEAL CANDIDATE? We are looking for an enthusiastic candidate to fill a Workers Compensation Associate position. Ideal candidates will thrive in a collaborative team environment, show motivation and drive in their work ethic, are customer-oriented, naturally empathic and solution-focused.

ESSENTIAL RESPONSIBILITIES MAY INCLUDE

  • Adjusts medical-only claims and minor lost-time workers compensation claims under close supervision.

  • Supports other claims representatives, examiners and leads with larger or more complex claims as necessary.

  • Processes workers compensation claims determining compensability and benefits due; monitors reserve accuracy, and files necessary documentation with state agency.

  • Communicates claim action/processing with claimant, client and appropriate medical contact.

  • Ensures claim files are properly documented, and claims coding is correct.

  • May process routine payments and prescriptions and status reports for lifetime medical claims and/or defined period medical claims.

  • Maintains professional client relationships

QUALIFICATIONS

  • Education & Licensing: High school diploma or GED required

  • Skills: Strong oral and written communication, computer literate - including Microsoft Office, organizational skills required

  • Experience: Clerical or customer service experience or equivalent combination of education and experience preferred

TAKING CARE OF YOU

  • Flexible work schedule.

  • Ability to work in an agile environment

  • Referral incentive program.

  • Career development and promotional growth opportunities.

  • A diverse and comprehensive benefit package offering including medical, dental vision, 401K.

WORK ENVIRONMENT REQUIREMENTS INCLUDE

When applicable and appropriate, consideration will be given to reasonable accommodations.

  • Mental:?Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

  • Physical:?Computer keyboarding

  • Auditory/Visual: Hearing, vision and talking

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is ($20-$24/hour). A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see sedgwick.com


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