Case Management Associate
Sedgwick · Tennessee, United States · 1 wk ago
RemoteRemoteOTHRFull-time
About the role
Join Sedgwick, a global industry leader, and be part of a meaningful mission supporting people facing the unexpected. As a Case Management Associate, you’ll deliver innovative customer-facing solutions to clients across diverse industries, leveraging Sedgwick’s broad network of experts. This role offers flexibility, autonomy, and opportunities for professional growth within a rapidly expanding company known for excellence and customer service.
Responsibilities
- Access and assign workers compensation, disability, and liability cases in compliance with state laws and company policies.
- Provide accurate information to callers, triaging requests between utilization review, clinical consultation, and telephonic case managers.
- Enter and maintain new claims data in the claims management system, ensuring data integrity.
- Support clinical staff by completing components of the case management and utilization review process.
- Schedule diagnostic tests and physician appointments as assigned.
- Direct injured workers, employers, and claims examiners into the PPO network for treatment (channeling services).
- Gather statistics for record-keeping and generate required reports.
- Confirm receipt of faxed forms and filings for regulatory agencies; distribute, fax, mail, and copy correspondence.
Requirements
- One (1) year of administrative experience required.
- Customer service experience in a medical field preferred.
- Workers compensation, disability, and/or liability claims processing experience preferred.
Qualifications
Associate's degree or two (2) years of college preferred.
Work Environment
- Mental: Clear and conceptual thinking ability; excellent judgment, problem-solving, and analytical skills; ability to handle work-related stress, multiple priorities, and deadlines.
- Physical: Computer keyboarding.
- Auditory/Visual: Hearing, vision, and verbal communication.
Reasonable accommodations will be considered when applicable and appropriate.
Benefits
- Flexible work schedule.
- Referral incentive program.
- Agile work environment.
- Career development and promotional growth opportunities.
- Comprehensive benefits package, including medical, dental, vision, and 401K (available on day one).