Patient Care Coordinator-Bilingual Preferred

Sedgwick Claims Management Services Ltd; Northern (KY); Hybrid; USD 34,000 - 42,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401k with company match

PTO

Disability insurance

Life insurance

Employee assistance program

Flexible spending account

Job summary

Sedgwick seeks a Patient Care Coordinator to provide world class customer service by processing referrals for medical goods and services. You will confirm patient demographics, liaise with vendor partners and claims professionals, and ensure referrals are medically necessary and properly billed.

The role requires strong communication, organizational skills, and the ability to work in a team. High school diploma and 2 years of healthcare scheduling experience are expected; travel may be required.

Qualifications

• High school diploma or GED required.
• Two years of healthcare network and patient care scheduling experience.
• Strong communication and MS Office proficiency.

Responsibilities

• Reaches out to patients to confirm demographics and referral status.
• Communicates with vendor partners, claims adjusters and nurse case managers.
• Procur es vendor partners for each referral as needed.
• Makes or takes calls on referrals and related team referrals.
• Provides quotes to clients and obtains written approvals for referrals.
• Ensures billing information exists and referrals are billed daily.
• Processes referrals per state regulations and workers' compensation guidelines.

Skills

Customer service

Critical thinking

Self-starter

Communication

MS Office

Analytical

Organizational skills

Interpersonal skills

Written reports

Teamwork

Performance competencies

Education

High school diploma or GED

Tools

Microsoft Office

Job description

Patient Care Coordinator-Bilingual Preferred

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

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).

• 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.

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