Remote Case Management Specialist (Medical Claims)

Sedgwick; Boise (ID); On-site; USD 23,000 - 28,000; Full time

Benefits offered by this job

Flexible schedule

Referral program

Agile environment

Career development

Benefits package

Job summary

Sedgwick is hiring a Case Management Associate for a US telecommuter, full-time position. You will access and assign workers’ compensation, disability and liability cases, providing primary support to medical staff within a team environment.

Requirements include an associate degree or two years of college and at least one year of administrative experience; medical field customer service is preferred and prior claims processing experience is a plus.

Qualifications

• Associate's degree or two years of college preferred.
• One year of administrative experience required.
• Customer service experience in a medical field preferred.
• Workers' compensation, disability and/or liability claims processing experience preferred.

Responsibilities

• Accesses and assigns cases for medical case management, utilization review and clinical consultation.
• Provides accurate information to callers and triages telephone inquiries.
• Enters new claims data into the claims management system and maintains data integrity.
• Supports clinical staff through components of case management and utilization review.
• Schedules diagnostic tests and physician appointments.
• Directs to PPO network for treatment and gathers statistics for reports.
• Ensures receipt of fax forms and filings required by regulators.
• Distributes, faxes, mails and copies incoming and outgoing correspondence.

Skills

Administrative experience

Customer service

Education

Associate degree

Job description

Sedgwick is hiring a Case Management Associate for a US telecommuter, full-time position. You will access and assign workers’ compensation, disability and liability cases, providing primary support to medical staff within a team environment.

Requirements include an associate degree or two years of college and at least one year of administrative experience; medical field customer service is preferred and prior claims processing experience is a plus.