Service Center Representative

Sedgwick Claims Management Services Ltd; Dublin (OH); On-site; USD 36,000 - 48,000; Full time

Job summary

Sedgwick Claims Management Services Ltd is seeking a Service Center Representative to provide exceptional caller support on multiple lines of business. The role emphasizes accurate data capture, timely processing of claims applications, and concise documentation of call notes.

You will educate customers on documents, timeframes, and payment details, while directing calls to the proper escalation path. Strong communication, medical terminology knowledge, and the ability to multitask in a

Qualifications

• High school diploma or GED required. College courses preferred.
• One (1) year customer service experience or equivalent combination of education and experience required.
• Inbound call center experience preferred.

Responsibilities

• Acts as primary liaison with callers and follows client specifications in assisting with questions and solving problems related to the claims application and servicing processes.
• Educates and informs customers 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.
• Performs other duties as assigned.
• Supports the organization’s quality program(s).

Skills

Customer service

Communication

Multitasking

Team player

Medical terminology

Education

High school diploma or GED

Tools

Microsoft Office

Job description

Service 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.

Responsibilities

• Acts as primary liaison with callers and follows client specifications in assisting with questions and solving problems related to the claims application and servicing processes.
• Educates and informs customers 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.
• Performs other duties as assigned.
• Supports the organization’s quality program(s).

Qualifications

• High school diploma or GED required. College courses preferred.
• 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 multitask in a 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.

Additional Information

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.

EEO Statement

Sedgwick is an Equal Opportunity Employer and a Drug‑Free Workplace.