Service Center Representative (Remote) 2025-1428 at Managed Care Advisors in Orlando, Florida

Job Description:

Position Title: Service Center Representative (Remote) 2025-1428

Location: Orlando, FL, USA

Job Category: NPN Operations

Job Type: Full Time

Description:

Remote Service Center Representative - Nation Wide Position

IF YOU CARE, THERE’S A PLACE FOR YOU HERE

Overview

Are you focused on details, skilled in claims management, and committed to problem-solving and exemplary customer service? Are you looking to make a difference by supporting claims processing for members of the World Trade Center Health Program impacted by the September 11th terrorist attacks?

As a Sedgwick Government Solutions remote Service Center Representative, you will work from your home office from 12-8 pm Eastern and be part of a collegial team that processes claim and communicate with providers about the claims process. In this position, you are responsible for daily claims management and will be recognized as a general technical expert in the benefits of this unique limited health benefits program. You will expedite the claims process and provide detailed claim notes on all calls; as well as resolve issues and direct calls to an appropriate escalation path as 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 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

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. 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 to complete 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 of 41 CFR 60-741.5(a). 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 of 41 CFR 60-300.5(a). 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

Sedgwick Government Solutions is a fully owned subsidiary of Sedgwick. Sedgwick is a leading global provider of technology-enabled risk, benefits, and integrated business solutions. Taking care of people is at the heart of everything we do. Millions of people and organizations count on Sedgwick each year to take care of their needs when they face a major life event or something unexpected happens. The company provides a broad range of resources tailored to clients' specific needs in casualty, property, marine, benefits, and other lines. At Sedgwick, caring counts; through the dedication and expertise of more than 27,000 colleagues across 65 countries, the company takes care of people and organizations by mitigating and reducing risks and losses, promoting health and productivity, protecting brand reputations, and containing costs that can impact the bottom line. www.sedgwick.com Privacy | Sedgwick Terms and Conditions | Sedgwick

Equal employment opportunity, including veterans and individuals with disabilities.

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