[Hiring] Consumer Care Advocate @Sedgwick

Role Description

To provide high quality service to both internal and external customers, delivering an easy and efficient customer experience for routine lost time.

• Processes incoming calls, faxes and voicemails from claimants, providers, clients, attorneys, etc., resolving their claims related questions and issues in accordance with designed guidelines and policies.
• Communicates claims status and current claim activity with client and appropriate medical contact; responds to inquiries about jurisdiction- and claim-specific issues.
• Enters data into claims system(s) and ensures claim files are properly documented and claims coding is correct.
• Coordinates claimant address updates or changes with internal departments.
• Provides referrals to legal, utilization review, pharmacy, and Special Investigations Unit (SIU) as appropriate and coordinates independent medical examinations.
• Performs other duties as assigned.
• Supports the organization's quality program(s).

Qualifications

• High school diploma or GED required.
• Associate’s degree from an accredited college or university preferred.
• Professional certification as applicable to line of business preferred.
• Two (2) years of administrative and/or customer service experience or equivalent combination of education and experience required.
• Excellent oral and written communication skills.
• PC literate, including Microsoft Office products.
• Strong investigation and organizational skills.
• Good interpersonal skills.
• Ability to work in a team environment.
• Ability to meet or exceed Performance Competencies.

Requirements

• 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.
• Computer keyboarding, travel as required.
• Hearing, vision and talking.

Benefits

• Recognized as America’s Greatest Workplaces National Top Companies by Newsweek.
• Certified as a Great Place to Work®.
• Listed in Fortune Best Workplaces in Financial Services & Insurance.