Service Center Representative
CLAIM YOUR FUTURE AS A GREAT PERFORMER!
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 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).
Education & Licensing
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 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
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
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.
Sedgwick is an Equal Opportunity Employer