Patient Care Coordinator

Sedgwick Claims Management Services Ltd; Orlando, Washington (FL, Washington County); On-site; USD 22,000 - 28,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401(k) matching

Paid time off

Job summary

Sedgwick is seeking a Patient Care Coordinator in Orlando to deliver world class customer service for referrals of medical goods and services. You will verify patient information, coordinate with vendor partners and nurse case managers, and ensure referrals are medically necessary and billable.

The role requires strong communication, scheduling experience, and proficiency with Microsoft Office in a fast-paced team environment.

Qualifications

• High school diploma or GED required.
• Two (2) years of industry experience in healthcare network and patient care scheduling or equivalent combination of education and experience required.
• Strong customer service and communication skills.
• PC literate, including Microsoft Office products.
• Analytical and interpretive skills.

Responsibilities

• Reaches out to patients to confirm demographics and delivery of referrals.
• Communicates with vendor partners, claims adjusters and nurse case managers providing updates on referrals.
• Procures vendor partners for each referral as it relates to goods or services requested.
• Makes or takes phone calls on referrals, new or existing.
• Provides quotes to clients for approval and ensures medical necessity and approval by the adjuster.
• Confirms billing information and moves referrals to billing daily.
• Processes referrals per state regulations and workers compensation guidelines.

Skills

Customer service

Communication

Teamwork

Time management

Problem solving

Education

High school diploma or GED

Tools

Microsoft Office

Job description

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.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is (17an hour).

• A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

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