Consumer Care Advocate

Sedgwick; Raleigh (NC); Presencial; USD 36.000 - 48.000; Jornada completa

Descripción de la vacante

Sedgwick in Raleigh, NC seeks a Consumer Care Advocate to deliver high-quality service to claimants and clients, handling calls, data entry, and referrals. The role emphasizes accuracy, responsiveness, and compliance with guidelines.

The position requires strong communication, teamwork, and proficiency with MS Office. A high school diploma or GED is required, with an Associate’s degree preferred and two years of related experience advantageous.

Formación

• Excellent oral and written communication skills.
• PC literate, including Microsoft Office products.
• Strong investigation and organizational skills.
• Ability to work in a team environment.

Responsabilidades

• Processes incoming calls, faxes and voicemails from claimants, providers, clients, attorneys, etc.
• Responds to inquiries about status and activity; communicates with clients and medical contacts.
• Enters data into claims system and ensures proper documentation and coding.
• Coordinates address updates with internal departments; provides referrals as needed.

Conocimientos

Excellent communication

Microsoft Office

Teamwork

Organizational skills

Educación

High school diploma or GED

Associate's degree (preferred)

Herramientas

MS Office

Descripción del empleo

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 CompaniesCertified as a Great Place to WorkFortune Best Workplaces in Financial Services & InsuranceConsumer Care AdvocatePRIMARY 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 RESPONSIBILITIESProcesses 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 RESPONSIBILITIESPerforms other duties as assigned.Supports the organization's quality program(s).QUALIFICATIONSEducation & LicensingHigh school diploma or GED required. Associate’s degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred.ExperienceTwo (2) years of administrative and/or customer service experience or equivalent combination of education and experience required.Skills & KnowledgeExcellent oral and written communication skillsPC literate, including Microsoft Office productsStrong investigation and organizational skillsGood interpersonal skillsAbility to work in a team environmentAbility to meet or exceed Performance CompetenciesWORK ENVIRONMENTWhen applicable and appropriate, consideration will be given to reasonable accommodations.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 deadlinesPhysical: Computer keyboarding, travel as requiredAuditory/Visual: Hearing, vision and talkingThe 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 timeSedgwick 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.