Consumer Care Advocate

Sedgwick•Telecommuter TX, SC

2d•Hybrid

About The Position

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. At Sedgwick, you're more than an employee, you're part of a team that supports, empowers, and celebrates your success every step of the way. Enjoy a dependable work environment with both in-office and virtual opportunities. Start strong with comprehensive training designed to help you confidently support employees and customers from some of the world's most recognized brands. Receive guidance from dedicated leaders and mentors who are invested in your growth and success. Take your career to the next level with ongoing development, new challenges, and opportunities for advancement. Our inclusive benefits package is designed to support your physical, mental, financial, and professional well-being. Join a team where your contributions matter, your growth is encouraged, and your future is full of possibilities. Your next big opportunity starts here—are you ready to join us?

Requirements

High school diploma or GED required.
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

Nice To Haves

Associate’s degree from an accredited college or university preferred.
Professional certification as applicable to line of business preferred.

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