Job Location: Memphis, TN – Thousand Oaks Blvd.
Application Closing date – June 30
Consumer Care Advocate – Bilingual (Spanish)
CLAIM YOUR FUTURE AS A GREAT PERFORMER!
Providing both satisfying and challenging work along with a highly professional and friendly work atmosphere, Sedgwick has a strong commitment to its colleagues and its clients. If you are seeking a place where you can do great things for those whose lives you touch while maximizing your own career possibilities, Sedgwick is the place for you. As the largest and most innovative Third Party Administrator in the claims industry and the first and only TPA to receive both recognition as the Best TPA in America and the coveted Employer of Choice designation, we invite you to come be a part of our team and, “Claim Your Future.”
|PRIMARY PURPOSE: To receive and handle complex task assignments and to coordinate work assignments to support various claim types and work act|
|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).
Education & Licensing
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
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.
Additional Information: Specific workdays and hours will be assigned based on business needs taking into account candidate preferences, when possible.
Proficiency in Spanish required.