Patient Care Coordinator

Sedgwick Claims Management Services Inc.

United States

Remote

USD 19,000 - 28,000

Full time

14 days+

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Benefits offered by this job

Medical

Dental

Vision

401k and matching

PTO

Disability and life insurance

Employee assistance

HSAs/FSAs

Other voluntary benefits

Job summary

Sedgwick Claims Management Services Inc. is seeking a Patient Care Coordinator to deliver world class customer service by processing referrals for medical goods and services.

You will coordinate with patients, vendors, and claim teams to ensure timely, accurate referrals and compliant billing. The role requires a high school diploma or GED and at least two years of healthcare scheduling experience, with strong communication and organizational skills.

Qualifications

High school diploma or GED required.
Two (2) years of healthcare network and patient care scheduling experience or equivalent.
Strong customer service and communication skills.
Proficiency with Microsoft Office products.
Ability to work in a team and meet deadlines.

Responsibilities

Reaches out to patients to confirm demographic information and updates on referrals.
Communicates with vendor partners, claims adjusters and nurse case managers.
Procures vendor partners for each referral.
Makes or takes calls on referrals.
Provides quotes and secures written approval for referrals deemed medically necessary.
Ensures billing information is complete and moves referrals to billing daily.
Processes referrals per state regulations and workers' compensation guidelines.
Performs other duties and supports quality programs.
Travels as required.

Skills

Strong customer service skills

Strong critical thinking skills

Self-Starter

Excellent oral and written

PC literate

Analytical and interpretive

Strong organizational

Excellent interpersonal

Written reports

Team player

Performance competencies

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

NOTE:

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.