Consumer Care Advocate

Sedgwick

119d • Remote

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. 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.

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).

What This Job Offers

• Job Type: Part-time
• Career Level: Entry Level
• Industry: Insurance Carriers and Related Activities
• Education Level: High school or GED