Care Team Representative

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve.

Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies

Certified as a Great Place to Work

Fortune Best Workplaces in Financial Services & Insurance

Care Team Representative

PRIMARY PURPOSE: To provide excellent service displaying empathy to callers regarding claims for multiple lines of business, including but not limited to, expediting the claims process and providing detailed claim notes on all calls, resolving issues with one call/one person response, and directing calls to appropriate escalation path as needed.

ESSENTIAL FUNCTIONS And RESPONSIBILITIES

• Acts as primary liaison with callers from multiple client accounts within a shared services environment.
• Follows specifications in assisting with questions and solving problems related to the claims application and servicing processes.
• Performs claim intake and full-service customer support within regulatory requirements, company, and client expectations at all times.
• Educates and informs the customer about documentation required to file/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 claim information that meets both the internal and external customer’s requirements accurately into the appropriate 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.
  
  

ADDITIONAL FUNCTIONS And RESPONSIBILITIES

• Performs other duties as assigned.
  
  

QUALIFICATIONS

Education & Licensing High school diploma or GED required.

Experience

One (1) year customer service experience or equivalent combination of education and experience required. Inbound call center experience preferred.

Skills & Knowledge

• Excellent verbal and written communication skills
• PC literate, including Microsoft Office products, Windows environment
• Must meet minimum typing requirements
• 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
• Ability to meet all attendance expectations
  
  

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.

We are committed to inclusive, barrier-free recruitment and selection processes. If contacted for an employment opportunity, please advise Colleague Resources if you require accommodation.

OBJECTIF PRINCIPAL : Fournir un excellent service faisant preuve d'empathie envers les appelants concernant les réclamations concernant plusieurs secteurs d'activité, y compris, mais sans s'y limiter, accélérer le processus de réclamation et fournir des notes de réclamation détaillées sur tous les appels, résoudre les problèmes en répondant à un seul appel/une seule personne et diriger les appels vers les personnes ressource appropriées, selon les besoins.

FONCTIONS ET RESPONSABILITÉS ESSENTIELLES

• Agir comme agent de liaison principal avec les appelants de plusieurs comptes clients dans un environnement de services partagés.
• Suivre les spécifications pour répondre aux questions et résoudre les problèmes liés aux processus de demande de réclamation et de service.
• Effectuer à tout moment la réception des réclamations et assure un service à la clientèle complet dans le respect des exigences réglementaires, de l'entreprise et des attentes des clients.
• Éduquer et informer le client sur la documentation nécessaire pour déposer/traiter une réclamation, les délais requis, les informations de paiement et l'état de la réclamation.
• Éduquer les demandeurs/appelants sur les exigences des clients et les régimes d’avantages sociaux en documentant tous les détails requis de l’appel de manière concise et professionnelle.
• Saisir les informations de réclamation verbales et écrites qui répondent avec précision aux exigences du client interne et externe dans le système approprié.
• Diriger les appels des clients vers le contact approprié à plusieurs endroits ou les transmet au spécialiste/à la direction du centre de service à la clientèle si nécessaire.
• La présence pendant les heures de travail prévues est requise.
  
  

FONCTIONS ET RESPONSABILITÉS SUPPLÉMENTAIRES

• Disponibilité pour le travail par quarts de travail (jours, soirs et nuits incluant les fins de semaine)
• Effectuer d'autres tâches connexes.
• Se déplacer selon les besoins.
  
  

QUALIFICATIONS

• Formation et certification
• Diplôme d’études secondaires ou l'équivalent (GED) requis
  
  

Expérience

• Un (1) an d'expérience en service à la clientèle ou une combinaison équivalente de formation et d'expérience requise. Expérience en centre d'appels entrants, de préférence.
  
  

Sedgwick is an Equal Opportunity Employer.

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. Sedgwick retains the discretion to add or to change the duties of the position at any time.