Patient Care Coordinator

Sedgwick Claims Management Services Ltd; Town of Florida (NY); On-site; USD 19,000 - 28,000; Full time

Job summary

Sedgwick is seeking a Patient Care Coordinator in New York to provide world-class customer service and manage referrals for medical goods and services. The role involves contacting patients, coordinating with vendors and claims teams, and ensuring referrals are billed correctly and medically necessary.

The candidate should have at least two years in healthcare scheduling or a related field, with strong communication, organizational, and reporting skills.

Qualifications

• High school diploma or GED required.
• 2 years of healthcare network and patient care scheduling experience or equivalent combination of education and experience.
• Strong customer service, communication and organizational skills.
• Ability to create and complete comprehensive, accurate written reports.
• Ability to work in a team and meet deadlines.

Responsibilities

• Reaches out to patients regarding referrals, confirms demographics, updates referrals and confirms delivery of goods/services.
• Communicates with vendor partners, claims adjusters and nurse case managers with updates on referrals.
• Procures vendor partners for referrals and ensures medical necessity and approval by the adjuster.
• Handles calls on existing or new referrals and related team referrals.
• Provides quotes to clients and verifies billing information for referrals.

Skills

Customer service

Critical thinking

Communication skills

Organizational skills

Teamwork

Analytical skills

MS Office

Report writing

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 CompaniesCertified as a Great Place to WorkFortune Best Workplaces in Financial Services & InsurancePatient Care CoordinatorPRIMARY 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 RESPONSIBILITIESReaches 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 RESPONSIBILITIESPerforms other duties as assigned.Supports the organization's quality program(s).Travels as required.QUALIFICATIONSEducation & LicensingHigh school diploma or GED required.ExperienceTwo (2) years of industry experience in healthcare network and patient care scheduling or equivalent combination of education and experience required.Skills & KnowledgeStrong customer service skillsStrong critical thinking skillsSelf-StarterExcellent oral and written communication skillsPC literate, including Microsoft Office productsAnalytical and interpretive skillsStrong organizational skillsExcellent interpersonal skillsAbility to create and complete comprehensive, accurate and constructive written reportsAbility to work in a team environmentAbility to meet or exceed Performance CompetenciesWORK ENVIRONMENTWhen 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 deadlinesPhysical : Computer keyboarding, travel as requiredAuditory/Visual : Hearing, vision and talkingNOTE : Credit security clearance, confirmed via a background credit check, is required for this position.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 $17.00. 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.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.