Case Management Associate

📋 Description

• • As a Case Management Associate at Sedgwick Claims Management Services, Inc., you will play a pivotal role in supporting individuals navigating the complexities of workers' compensation, disability, and liability claims. This telecommuting position, based in Tennessee, offers a unique opportunity to contribute to a meaningful mission of helping people through unexpected life events, all while fostering your professional growth within a supportive and award-winning organization.
• • Your primary responsibility will be to meticulously access and assign incoming cases, ensuring they are directed to the appropriate medical case management, utilization review, or clinical consultation teams. This involves a deep understanding and strict adherence to current company policies and procedures, as well as the specific workers' compensation laws of various states.
• • You will serve as a crucial point of contact, providing accurate and timely information to callers, effectively triaging telephone inquiries, and directing them to the correct specialists within the case management framework. This requires excellent communication skills and the ability to quickly assess and respond to diverse needs.
• • A key aspect of your role will be the precise entry of new claims data into the company's claims management system. Maintaining the integrity and accuracy of this data is paramount, as it forms the foundation for all subsequent case management activities and reporting.
• • You will actively support the clinical staff by completing essential components of the case management and utilization review processes. This collaborative effort ensures that cases are managed efficiently and effectively, leading to optimal outcomes for claimants.
• • This role involves coordinating essential services for claimants, including scheduling diagnostic tests and physician appointments as directed. Your organizational prowess will be vital in ensuring these appointments are booked accurately and efficiently.
• • You will also be instrumental in providing channeling services, guiding injured workers, employers, and claims examiners to appropriate PPO networks for necessary medical treatment. This ensures that individuals receive the right care from qualified providers.
• • To maintain operational efficiency and compliance, you will be responsible for gathering statistics for record-keeping purposes and generating reports as required. This analytical component of the role contributes to the overall performance tracking and improvement of the case management department.
• • Furthermore, you will confirm the receipt of all required fax forms and filings from regulatory agencies, ensuring timely distribution, faxing, mailing, and copying of incoming and outgoing correspondence. This meticulous attention to detail is critical for compliance and smooth operations.
• • Sedgwick is recognized for its commitment to its employees, being named one of America's Greatest Workplaces by Newsweek, certified as a Great Place to Work®, and acknowledged by Fortune for its Best Workplaces in Financial Services & Insurance. Joining Sedgwick means becoming part of a culture that values caring, collaboration, and work-life balance.
• • This position offers the flexibility of a blended work environment, allowing you to contribute effectively from your home office. You will be empowered to engage in meaningful work that stimulates critical thinking and problem-solving, contributing directly to the well-being of others.
• • Sedgwick is dedicated to your professional development, providing ongoing learning opportunities and pathways for career advancement. You will be part of a strong team environment that fosters a culture of support, where successes are recognized and achievements are celebrated.
• • The company offers a comprehensive benefits package designed to support your health, financial well-being, and personal growth, reflecting their commitment to taking care of their employees.
• • By joining Sedgwick, you are not just taking a job; you are embarking on a career path with a company that is a leader in its industry and deeply committed to its people and the communities it serves.