Patient Care Coordinator
Sedgwick
US Telecommuter
R78365
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
Patient Care Coordinator
PRIMARY PURPOSE : To provide world class customer service and service delivery to our clients and patients through processing referrals in the delivery of medical goods and services.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Reaches out to patients in relation to new or already processing referrals confirming patient demographic information, providing updates on the referral, and/or confirming delivery of said goods or service.
Communicates with vendor partners, claims adjusters and nurse case managers providing updates on new referrals as well as referrals already in process.
Procures vendor partners for each referral as it relates to the goods or services requested.
Responsible for making or taking phone calls on existing referrals, new referrals, or other team members referrals.
Provides quotes back to clients for approval or follow up on quotes already sent to obtain written approval for requested referrals ensuring that each referral is deemed medically necessary and approved by the claim’s adjuster.
Confirms all required and relevant billing information exists in each referral as it relates to the workflow and billing processes in place and moves those referrals to be billed each day.
Processes referrals per state regulations and workers compensation guidelines.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
Performs other duties as assigned.
Supports the organization's quality program(s).
Travels as required.
QUALIFICATIONS
Education & Licensing
High school diploma or GED required.
Experience
Two (2) years of industry experience in healthcare network and patient care scheduling or equivalent combination of education and experience required.
Skills & Knowledge
Strong customer service skills
Strong critical thinking skills
Self-Starter
Excellent oral and written communication skills
PC literate, including Microsoft Office products
Analytical and interpretive skills
Strong organizational skills
Excellent interpersonal skills
Ability to create and complete comprehensive, accurate and constructive written reports
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, 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.
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
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