Consumer Care Advocate

Sedgwick; Texas; On-site; USD 23,000 - 28,000; Full time

Benefits offered by this job

Career stability

Comprehensive training

Personalized coaching

Growth opportunities

Competitive benefits

Impactful work

Job summary

Sedgwick in Texas is seeking a Consumer Care Advocate to join our claims support team. You will handle inbound calls, assist claimants, and coordinate with providers and clients to deliver accurate, timely information and excellent service.

This role emphasizes high-quality communication, data entry, and collaboration within a supportive environment. It offers structured training, opportunities to grow, and benefits as part of a stable, inclusive workplace.

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 (2) years of administrative and/or customer service experience or equivalent combination of education and experience required.
• PC literate, including Microsoft Office products.

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.

Skills

Excellent oral and written command of沟

Education

High school diploma or GED

Associate's degree preferred

Professional certification as applicable to line of business

Tools

Microsoft Office

Job description

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

Consumer Care Advocate

Build Your Future with a Team That Wins Together!

Why You'll Love Working Here:

• A Career Built on Stability
• A comprehensive training program
• Personalized Support & Coaching
• Endless Opportunities to Grow
• Benefits That Put You First
• Join a team where your contributions matter, your growth is encouraged, and your future is full of possibilities.

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).

QUALIFICATIONS

Education & Licensing

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.

Experience

Two (2) years of administrative and/or customer service experience or equivalent combination of education and experience required.

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

WORK ENVIRONMENT

When 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 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.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $17.00. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

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.