Overview
IF YOU CARE, THERE’S A PLACE FOR YOU HERE
The Service Center Representative communicates with providers, members and
designated representatives. The position is recognized as a general technical
expert in the health benefits program. The Service Center Representative
provides detailed claim notes on all calls; as well as resolves issues and
directs calls to an appropriate escalation path if needed.
Remote Service Center Representative Responsibilities
* Acts as primary liaison with callers; follows client specifications in
assisting with questions and solving problems related to the claims process
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 members and providers 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.
* 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).
Remote Service Center Representative Required Qualifications
* A high school diploma or GED is required. College courses preferred
* One (1) year of customer service experience or an equivalent combination of
education and experience is required. Inbound call center experience
preferred.
* 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
* This role requires a security clearance, including verification through a
comprehensive background and credit check.
* US citizen
NEXT STEPS
If your application is selected to advance to the next round, a recruiter will
be in touch.
For a career path that is both challenging and rewarding, join Sedgwick
Government Solution’s talented team. Taking care of people is at the heart of
everything we do. Our clients depend on our talented colleagues to take care of
their most valuable assets—their employees and their customers. At Sedgwick
Government Solutions, caring counts®. Join our team of creative and caring
people of all backgrounds and help us make a difference in the lives of others.
Sedgwick Government Solutions 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 a
specific location. For the jurisdiction noted in this job posting only, the
range of starting pay for this role is (). 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.
To be considered for this position, please submit a resume and complete the
application.
The information provided above has been designed to indicate the general nature
and level of work of the position. It is not a comprehensive inventory of all
duties, responsibilities, and qualifications required.
Important Information
Successful candidates will be required to undergo a financial and criminal
background check and obtain and maintain confidential-level security clearance
upon hire. We participate in the United States Federal Government E-Verify
program to confirm the employment authorization of the employee upon hire.
Search Firm Representatives
Please be advised that Sedgwick Government Solutions (Government Solutions) is
not seeking assistance or accepting unsolicited resumes from search firms for
this employment opportunity. Regardless of past practice, a valid written
agreement and task order must be in place before any resumes are submitted to
Government Solutions. All resumes submitted by search firms to any employee at
Government Solutions without a valid written agreement and task order in place
will be deemed the sole property of Government Solutions and no fee will be paid
in the event that person is hired by Government Solutions.
Government Solutions strives to make our career site accessible to all users. If
you need a disability-related accommodation for completing the application
process, please contact Government Solutions regarding accommodations.
Sedgwick Government Solutions is an Equal Opportunity and Affirmative Action
Employer
All qualified applicants will receive consideration for employment without
regard to age, citizenship status, color, disability, marital status, national
origin, race, religion, sex, sexual orientation, gender identity, veteran
status, or any other classification protected by federal state or local laws as
appropriate, or upon the protected status of the person’s relatives, friends or
associates.
Sedgwick Government Solutions abides by the requirements of41 CFR 60-741.5(a)
[http://www1.eeoc.gov/employers/upload/eeoc_self_print_poster.pdf]. This
regulation prohibits discrimination against qualified individuals on the basis
of disability and requires affirmative action by covered prime contractors and
subcontractors to employ and advance in employment qualified individuals with
disabilities.
Sedgwick Government Solutions abides by the requirements of41 CFR 60-300.5(a)
[http://www1.eeoc.gov/employers/upload/eeoc_gina_supplement.pdf]. This
regulation prohibits discrimination against qualified protected veterans and
requires affirmative action by covered prime contractors and subcontractors to
employ and advance in employment qualified protected veterans.
About Sedgwick Government Solutions
Sedgwick Government Solutions is a trusted partner for federal agencies across
the U.S., helping them confidently manage risk and claims. With decades of
experience and deep regulatory expertise, we keep agencies compliant while
improving their workforces’ health and productivity. Backed by the most advanced
technology, our tailored solutions help agencies navigate the complexities of
federal risk and claims management.Sedgwick Government Solutions
[https://www.sedgwickgovernment.com/]S
Sedgwick Government Solutions