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Patient Care Coordinator

Company: Sedgwick Claims Management Services, Inc.
Location: Clearwater
Posted on: November 22, 2021

Job Description:

The 'Apply with SEEK' option will be utilized for International applicants, mainly Australia. If this does not apply to you please use the 'Apply' option. Patient Care Coordinator IF YOU CARE, THERE'S A PLACE FOR YOU HERE For a career path that is both challenging and rewarding, join Sedgwick's talented team of 27,000 colleagues around the globe. Sedgwick is a leading provider of technology-enabled risk, benefits and integrated business solutions. Taking care of people is at the heart of everything we do. Millions of people and organizations count on Sedgwick each year to take care of their needs when they face a major life event or something unexpected happens. Whether they have a workplace injury, suffer property or financial loss or damage from a natural or manmade disaster, are involved in an auto or other type of accident, or need time away from work for the birth of a child or another medical situation, we are here to provide compassionate care and expert guidance. Our clients depend on our talented colleagues to take care of their most valuable assets-their employees, their customers and their property. At Sedgwick, caring counts--. Join our team of creative and caring people of all backgrounds, and help us make a difference in the lives of others. Primary Purpose This section contains two or three general statements describing the main functions performed. Example: To manage service delivery and client relationships within a specified region; to manage departmental budget; and to direct staff training and growth. 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 Describe five to seven major duties and responsibilities of the job, beginning with the most important, along with the percentage of time spent on each. Percentage of time must equal 100%. Example: 50% - Point of contact on assigned projects; performs a variety of duties including establishing project objectives, policies, procedures and performance standards within boundaries of company policy and project specifications; and confers with team members to discuss such matters as work progress, roadblocks and issue resolution. 15% - Formulates reports concerning such areas as work progress, costs and scheduling. % of Time Essential Functions & Responsibilities 10% * Reaching out to patients in relations to new or already processing referrals confirming patient demographic information, providing updates on the referral, or confirming delivery of said goods or service. 25% * Procuring vendor partners for each referral as it relates to the goods or services requested. 30% * Communicating with vendor partners, Claims adjusters and Nurse case managers, providing updates on new referrals as well as referrals already in process. 10% * Providing 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 claims adjuster. 15% * Making or Taking phone calls on existing referrals, new referrals, or other team members referrals. 5% * Confirming all required and relevant billing information exists in each referral as it relates to the workflow and billing processes in place and moving those referrals to be billed each day. 5% * Processing referrals per state regulations and workers compensation guidelines. Is travel required? If so, how much? No Does this position involve any financial or fiduciary responsibilities I.e. access to money, checks, financial or confidential information? No Describe the decision making responsibilities. N/A Does this position have budget responsibility/impact? If yes, describe. No Does this position have P&L responsibility/impact? If yes, describe. No Does this position have supervisory responsibilities? If yes, list job titles directly reporting to this position. No Qualifications Education: Describe the minimum education necessary to accomplish the job duties and responsibilities. In general, degrees are preferred except where necessary (i.e. attorney, registered nurse, CPA, etc.) Examples: Baccalaureate degree from an accredited college or university preferred. Bachelor's degree in finance or accounting from an accredited college or university is required. MBA preferred. For jobs that do not require a degree but a degree is preferred, if the candidate has a degree it may count toward some of the required experience. Generally an associate's may count for one year of experience, a bachelor's may count as 2 years of experience, and a master's may count as three years of experience. Non-exempt positions normally require only a high school diploma or GED. High School Diploma or Equivalent Licensing: Describe any licenses or certifications that are either required or helpful in performing the job. Please designate whether the license or certification is required or preferred. Examples: Certified Public Accountant (CPA) preferred. Registered Nurse (RN) certification required. N/A Page Break Experience: Describe minimum experience requirements necessary to accomplish the job duties and experience required. Examples: Four (4) years of claims management experience or equivalent education and experience required. Four (4) years of claims management experience including one (1) year of supervisory experience required or equivalent combination of education and experience. Preferred 1-3 Years Industry Experience, Healthcare Network and Patient care scheduling or similar Skills & Knowledge: Describe any special skills needed to perform the job duties. Examples: Other languages, special math or writing skills, experience with specific tools, equipment computer hardware/software, knowledge of special terminology. NOTE: The four skills listed below are standard. * World class customer service * Critical thinking * Self-Starter * Professionalism * Client Focused * Team Spirited * * * * Oral and written communication skills * Presentation skills needed? ? Yes ? No * PC literate, including Microsoft Office products * Ability to work in a team environment * Ability to meet or exceed Performance Competencies Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

Keywords: Sedgwick Claims Management Services, Inc., Clearwater , Patient Care Coordinator, Accounting, Auditing , Clearwater, Florida

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