Job Information
Sedgwick Case Coordinator in Cleveland, Ohio
Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.
A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work.
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Case Coordinator
PRIMARY PURPOSE : To gather claim data and manage low to mid-level workers compensation claims to full duty Return to work; facilitate appropriate treatment services efficiently, within required Ohio BWC Guidelines for compliance, company standards, industry best practices and/or client specific requirements to promote best outcomes.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Obtains expected elements for subsequent EDI to the Bureau of Workers Compensation (BWC).
Manages medical-only and low- to mid-level lost-time workers compensation claims under close supervision.
Processes workers compensation claims reviewing receipt of compensation; Treatment plans; facilitating services; collaborating with all claim parties with updates and changes.
Verifies return to work documentation through telephonic and written communications and records return to work dates appropriately in system(s).
Manages claims in close collaboration with Claims Management Team.
Supports other claims management staff with larger or more complex claims as necessary.
Makes referral for case management and/or utilization management when work status changes due to functional limitations/medical instability.
Documents communications and claims management appropriately in system(s).
Responds to all inquiries within one (1) business day.
Maintains knowledge of BWC rules and laws, workers compensation process, and CHS policies and procedures.
Maintains professional client relationships
Meets and maintains productivity and quality expectations
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
Performs other duties as assigned.
Supports the organization's quality program(s).
QUALIFICATIONS
Education & Licensing
High School diploma or GED required.
Experience
One (1) year case management experience or equivalent combination of education and experience required.
Skills & Knowledge
Knowledge of BWC Mandatory and Expected EDI Transmission elements
Good oral and written communication skills
PC literate, including Microsoft Office products
Good organizational and time management skills
Good customer service skills
Ability to work independently and in a team environment
Ability to manage multiple and changing priorities
Decision making/problem solving skills
Ability to meet or exceed Performance Competencies
WORK ENVIRONMENT
When applicable and appropriate, consideration will be given to reasonable accommodations.
Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
Physical: Computer keyboarding, travel as required
Auditory/Visual: Hearing, vision and talking
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.
Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.
Taking care of people is at the heart of everything we do. Caring counts
Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing – one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)
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