Consumer Care Advocate

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.

As a Consumer Care Advocate, your primary purpose will be to provide high-quality service to both internal and external customers, delivering an easy and efficient customer experience for routine lost time.

Responsibilities:

• Process 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.
• Communicate claims status and current claim activity with clients and appropriate medical contacts; respond to inquiries about jurisdiction- and claim-specific issues.
• Enter data into claims systems and ensure claim files are properly documented and claims coding is correct.
• Coordinate claimant address updates or changes with internal departments.
• Provide referrals to legal, utilization review, pharmacy, and Special Investigations Unit (SIU) as appropriate and coordinate independent medical examinations.

Additional Responsibilities:

• Perform other duties as assigned.
• Support the organization's quality programs.

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 years of administrative and/or customer service experience or equivalent combination of education and experience required.

Skills and Knowledge:

• Excellent oral and written communication skills.
• PC literacy, 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 demands include clear and conceptual thinking ability, excellent judgment, troubleshooting, problem-solving, analysis, and discretion.
• Physical demands include computer keyboarding and travel as required.
• Auditory/visual demands include hearing, vision, and talking.