Case Management Associate

Location

United States

Posted

26 days ago

Salary

0

Seniority

Mid Level

No structured requirement data.

Job Description

Case Management Associate

Sedgwick

Role Description To access and assign workers compensation, disability and liability cases applying current policies and procedures per state workers compensation laws; and to increase efficiency of operation by providing general customer support duties and supporting the medical staff in a team environment. We are looking for enthusiastic candidates who thrive in a collaborative environment, who are driven to deliver great work. Essential Functions and Responsibilities - Accesses and assigns cases for medical case management, utilization review and clinical consultation. - Provides accurate information to callers based on customer requests; triages telephone calls between utilization review, clinical consultation and telephonic case managers. - Enters new claims data into the claims management system accurately; maintains data integrity. - Supports clinical staff through the completion of components of the case management and utilization review process. - Schedules diagnostic tests and physician appointments as assigned. - Provides channeling services for injured workers, employers and claims examiners by directing into PPO network for treatment. - Gathers statistics for record keeping and provides reports as required. - Ensures by confirmation that fax forms and filings required by regulatory agencies have been received; distributes, faxes, mails and copies incoming and outgoing correspondence. Additional Functions and Responsibilities - Performs other duties as assigned. - Supports other units as required. - Supports the organization's quality program(s). Qualifications - Associate's degree or two (2) years of college preferred. - One (1) year of administrative experience required. - Customer service experience in a medical field preferred. - Worker's compensation, disability and/or liability claims processing experience preferred. - Knowledge of medical and insurance terms. - Knowledge of ICD 9 and CPT coding systems. - Excellent oral and written communication, including presentation skills. - PC literate, including Microsoft Office products. - Analytical and interpretive skills. - Strong organizational skills; detail-oriented. - Good interpersonal skills. - Ability to work in a team environment. - Ability to meet or exceed Performance Competencies. Requirements - Mental: Clear and conceptual thinking ability; excellent judgment 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. Benefits - Offering a blended work environment. - Supporting meaningful work that promotes critical thinking and problem solving. - Providing on-going learning and professional growth opportunities. - Promoting a strong team environment and a culture of support. - Recognizing your successes and celebrating your achievements. - We offer a diverse and comprehensive benefits package including: - Three Medical, and two dental plans to choose from. - Tuition reimbursement eligible. - 401K plan that matches 50% on every $ you put in up to the first 6% you save. - 4 weeks PTO your first full year.

Related Categories

Related Job Pages

More Ecommerce Jobs

Chuck Latham Associates, Inc. logo

eCommerce Pricing Administrator, Part Time

Chuck Latham Associates, Inc.

To deliver the best brand building, sales leadership, and retail services everywhere pet products are marketed or sold.

Ecommerce26 days ago
Part TimeRemoteTeam 501-1,000Since 1984H1B No Sponsor

• Monitor, track, and enforce MAP policy pricing across e-commerce channels including but not limited to Amazon, Chewy, Walmart, Petco, and Petsmart. • Thoroughly investigate each violation and compliance issue • Send violation notices and maintain detailed documentation of communications • Maintain tracker file of violations identified and notices sent.

United States
$23 - $27 / hour
Job Closed
Lago logo

Case Management Team Lead – Amazon, E-commerce

Lago

We connect talented individuals from emerging markets with top-tier remote job opportunities.

Ecommerce26 days ago
Full TimeRemoteTeam 1-10Since 2024H1B No Sponsor

• Supervises 4-8 Case Specialists (I/II/III), including 1:1s, goal setting, performance reviews, and career development conversations. • Coach Specialists on case-writing quality, tone with Seller Support, evidence attachment, and escalation triggers. • Set and enforce case-handling SOPs, templates, and escalation paths; approve deviations. • Run weekly team meetings and 1:1 • Track and report team-level KPIs (see below); drive root-cause analysis on misses. • Maintain and evolve the Case Management playbook • Identify recurring Seller Support failure patterns and create new solutions. • Partner with Brand Managers on case status, client-facing updates, and high-stakes escalations. • Coordinate with Listing Management, FBA Resolution, and Customer Service • Represent Case Management in department planning, tooling reviews, and process improvement projects.

Mexico
$10 - $20 / hour
Lago logo

Customer Service Team Lead – E-commerce

Lago

We connect talented individuals from emerging markets with top-tier remote job opportunities.

Ecommerce26 days ago
Full TimeRemoteTeam 1-10Since 2024H1B No Sponsor

• Lead a team of Customer Service Specialists, owning month-over-month team output and the individual growth of each direct report. • Run the team's operating cadence, including team meetings, one-on-ones, training, and performance reviews. • Monitor team KPIs and report on results, surfacing trends, risks, and opportunities to the Manager on a regular cadence. • Serve as the senior subject-matter expert across the team's customer service functions, and act as the escalation point for complex or sensitive cases. • Design, document, and continuously improve the SOPs, templates, and tools the team relies on, ensuring work is repeatable and audit-ready. • Uphold task management and reporting hygiene across the team, ensuring work is tracked, prioritized, and visible to stakeholders. • Onboard new specialists and run ongoing training, building the bench of capability across all customer service workflows. • Partner with adjacent Catalog teams (Listing, Case Management, Reimbursements) and with Account Managers to resolve cross-functional issues and align on client priorities. • Investigate performance gaps, take corrective action, and communicate clearly with the Manager on status, blockers, and next steps.

Mexico
$15 - $20 / hour
Lago logo

Customer Service Specialist, E-commerce

Lago

We connect talented individuals from emerging markets with top-tier remote job opportunities.

Ecommerce26 days ago
Full TimeRemoteTeam 1-10Since 2024H1B No Sponsor

• Through the use of company and department practices and procedures, independently manages buyer-seller messaging across an assigned book of client accounts • Owns end-to-end negative feedback and product review remediation workflows, including submission, follow-up, and escalation to Amazon when required • Coordinates return and refund decisions directly with brand management • Synthesizes trends (defect patterns, listing accuracy gaps, image/copy mismatches) and hands them off on a regular cadence to the Listing and Case Specialist teams • Identifies buyer complaints rooted in FBA issues (damaged inventory, wrong item shipped) and routes them to the FBA Resolution team with proper documentation • Utilizes structured escalation paths with Amazon for complex buyer-seller disputes • Acts as an SME or Trainual content owner for at least one Customer Service function (e.g., feedback removal, A-to-z claim prevention, returns) • Provides guidance to Customer Service Specialist I peers on day-to-day casework • Leverages external resources such as blogs, LinkedIn, and seller forums to stay current on Amazon buyer-side policy changes • Maintains or exceeds department-established performance standards • Other duties as assigned

Mexico
$10 - $15 / hour