Service Center Representative

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.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

• Acts as primary liaison with callers; follows client specifications in assisting with questions and solving problems related to the claims application and servicing processes.
• Educates and informs the customer 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.

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. College courses preferred

Experience 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 multi task in 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

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 $18.00. 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.