Call Center Representative - Sedgwick Claims Management Services, Inc.

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive. 

A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work.

Great Place to Work®
Most Loved Workplace® 
Forbes Best-in-State Employer

Call Center Representative

PRIMARY PURPOSE: To provide excellent service to callers regarding claims for multiple lines of business; to expedite the claims application process and provide detailed claim notes on all calls; to resolve issues with one call/one person response; and to direct calls to appropriate escalation path as needed.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Acts as primary liaison with callers; follows client specifications in assisting with questions and solving problems related to the claims application and servicing processes.
• Educates and informs the customer via multiple communication channels about documentation required to process a claim, required time frames, payment information, and claim status.
• Educates claimants/callers on client requirements and benefit plans documenting all required details of the call in a concise professional manner.
• Enters verbal and written application information that meets both the internal and external customer’s requirements accurately into the claims management system.
• Assigns new claims to the appropriate claims handler.
• Directs customer calls to the appropriate contact at multiple locations or escalates to Service Center Specialist/management as needed.
• Attendance during scheduled work hours is required.

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. College courses preferred

Experience
One (1) year customer service experience or equivalent combination of education and experience required. Inbound call center experience preferred.

Skills & Knowledge

• Knowledge of medical terminology
• Understanding of claims management
• Excellent oral and written communication skills
• PC literate, including Microsoft Office products
• Strong organizational skills
• Good interpersonal skills
• Ability to multi task in fast paced environment
• Ability to support multiple clients across communication channels and utilize multiple systems simultaneously
• Ability to work in a team environment and/or independently
• 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 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 and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.