Account Consultant Sr

Sedgwick • Austin, TX • 2h ago

Telecommuter TX

Full time

R80492

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.

Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies

Certified as a Great Place to Work®

Fortune Best Workplaces in Financial Services & Insurance

Account Consultant Sr

PRIMARY PURPOSE : To manage claim caseload of basic to highly complex claims within granted authority level including related financial implications, along with financial implications and to mentor Account Representatives and Account Specialists.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

Utilizes special account instructions to obtain individual customer information and adhere to instructions; identifies, initiates, and coordinates various specialized services such as subrogation, fraud evaluation or case management review to resolve claims.

Establishes and maintains effective relationship with internal and external customers and coworkers; communicates effectively and timely.

Mentors/coaches account representatives and account specialists; facilitates round table discussions within the assigned team.

Investigates, evaluates and resolves claims; identifies potential problems/trends in claim files and takes corrective action or makes corrective recommendations; interprets medical reports and state law or jurisdictional law in claim handling.

Applies jurisdictional and medical knowledge to properly assess the indemnity, medical and expense exposure of assigned claims and appropriately interprets and applies insurance coverage.

Reviews client files and collaborates with team to prepare information which includes thorough analysis of file strategies, claims status and emerging trends.

Proactively manages litigation in conjunction with client requirements; works constructively with client and legal representatives to resolve claims.

Ensures compliance and best possible outcomes by minimizing financial liability.

Compiles requirements in order to prevent penalties and fines; utilizes instructions and tools provided to ensure that all state required documentation is issued accurately and in timely manner in accordance with specific jurisdictional timeframes and guidelines.

Monitors reports as assigned and documents compliance with key jurisdictional requirements (i.e. EDI, timeliness of benefit payments, etc.); assists Team Lead in tracking completion of team's tasks and projects; reviews SAS/SOX documents and submits in timely manner; and assists with takeover and reverse takeover projects ensuring that claim files are transferred and handled appropriately.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

Performs other duties as assigned.

Supports the organization's quality program(s).

QUALIFICATIONS

Education & Licensing

Bachelor's degree from an accredited college or university preferred. State adjuster licenses required.

Experience

Six (6) years of related experience and/or training or equivalent combination of education and experience required.

Skills & Knowledge

Thorough legal and jurisdictional knowledge based on line of business

Strong oral and written communication, including presentation skills

PC literate, including Microsoft Office products

Analytical and interpretive skills

Strong organizational skills

Excellent interpersonal skills

Strong customer service skills

Ability to work in a team environment

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 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.

Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see sedgwick.com

Similar Jobs

Intelligent Systems - Project Manager- Washington D.C

Serco • Austin, TX • 1h ago

Management & Administrative

Position Description & Qualifications If you seek a rewarding, high profile and challenging position supporting projects for the US Navy- Serco has a great opportunity for you! This position will be on a dynamic team...

1h ago

Go to Apply

Cyber Senior Consultant: AI Security, Infrastructure

Deloitte • Austin, TX • 2h ago

Management & Administrative

As a AI Infrastructure Senior Consultant in our Cyber for AI team, you will lead technical workstreams that secure how artificial intelligence (AI) agents, workloads, and users authenticate, receive permissions, and acce...

2h ago

Go to Apply

Cyber - Senior Consultant, AI Data Security

Deloitte • Austin, TX • 2h ago

Management & Administrative

As a Sr Consultant: AI Data Security in Deloitte's Cyber for AI team, you will own technical workstreams that secure how enterprise data is ingested, transformed, retrieved, and used by GenAI, RAG, and other agentic syst...

2h ago

Go to Apply

Accenture Media Suite Presales Manager

Accenture • Austin, TX • 2h ago

Management & Administrative

THE ROLE As a Software Pre-Sales Manager, you will work closely with clients, sales teams, product teams, and other cross-functional stakeholders to understand business needs, shape software solutions, and communicate th...

2h ago

Go to Apply

Administrative Assistant IV-V

TEXAS COMMISSION ON LAW • Austin, TX • 2h ago

Management & Administrative

Please paste the following URL into a browser to view the entire job posting on the CAPPS Careers page.https://erphcmprd.cpa.texas.gov/psp/candidateportal/EMPLOYEE/HRMS/c/HRSHRAMFL.HRSCGSEARCHFL.GBL?Page=HRSAPPJBPSTFLand...

2h ago

Go to Apply

Administrative Assistant (Austin)

TEXAS WORKFORCE COMMISSION • Austin, TX • 2h ago

Management & Administrative

WHO WE ARE: The Texas Workforce Commission connects people with careers across the state. The State Office Appeals Department is searching for an Administrative Assistant I to join the team. This is an in-office position...

2h ago

Go to Apply

Executive Assistant to VP Service Operations

CVS Health • Austin, TX • 12h ago

Management & Administrative

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate...

12h ago

Go to Apply

Facility Operations Manager Senior

Applied Research Solutions • Kelly Usa, TX • 18h ago

Management & Administrative

Description Applied Research Solutions is seeking a full-time Facility Operations Manager located at Lackland A.F.B. San Antonio, Texas. The Facility Manager's primary function will be to track requested and scheduled pr...

18h ago

Go to Apply

Sr Operations Manager

Kelly Services • Austin, TX • 18h ago

Management & Administrative

Senior Operations Manager - Austin, TX Pay: $120,000 - $140,000/year + Bonus Schedule: Monday - Friday | 7:00 AM - 4:00 PM We're seeking an experienced Senior Operations Manager to oversee manufacturing operations at a p...

18h ago

Go to Apply

Customer Service Representative

Highmark Health • Austin, TX • 18h ago

Management & Administrative

Company : Highmark Inc. Job Description : JOB SUMMARY This Customer Service Representative job resolves standard and occasional non-standard customer inquiries, comments, and concerns by applying a seamless and positive...

18h ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)