Consumer Care Advocate
Sedgwick
Plano, TX, 62600 - Memphis, TN - 62600, Corporate Headquarters - 10000
21h ago

Job Description

Consumer Care Advocate

IF YOU CARE, THERE'S A PLACE FOR YOU HERE

For a career path that is both challenging and rewarding, join Sedgwick's talented team of 21,000 colleagues around the globe.

Sedgwick is a leading provider of technology-enabled risk, benefits and integrated business solutions. Taking care of people is at the heart of everything we do.

Millions of people and organizations count on Sedgwick each year to take care of their needs when they face a major life event or something unexpected happens.

Whether they have a workplace injury, suffer property or financial loss or damage from a natural or manmade disaster, are involved in an auto or other type of accident, or need time away from work for the birth of a child or another medical situation, we are here to provide compassionate care and expert guidance.

Our clients depend on our talented colleagues to take care of their most valuable assets their employees, their customers and their property.

At Sedgwick, caring counts®. Join our team of creative and caring people of all backgrounds, and help us make a difference in the lives of others.

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

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

  • 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.
  • ADDITIONAL FUNCTIONS and RESPONSIBILITIES

  • Performs other duties as assigned.
  • Supports the organization's quality program(s).
  • QUALIFICATIONS

    Education & Licensing 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.

    Experience Two (2) years of administrative and / or customer service experience or equivalent combination of education and experience required.

    Skills & Knowledge

  • 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
  • WORK ENVIRONMENT 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, travel as required

    Auditory / Visual : Hearing, vision and talking

    The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description.

    They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

    Sedgwick is an Equal Opportunity Employer

    Drug-Free Workplace

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