Patient Care Coordinator

Sedgwick • Telecommuter FL, FL

1d

About The Position

The Patient Care Coordinator provides service to callers regarding claims across multiple lines of business. The role expedites the claims application process, records detailed claim notes, resolves issues through one-call/one-person responses, and directs calls to the appropriate escalation path when needed. The coordinator serves as a primary liaison for callers, explains claim documentation, time frames, payment information, claim status, client requirements, and benefit plans, and accurately enters application information into the claims management system. The position also assigns new claims to the appropriate claims handler and routes or escalates calls as appropriate. Attendance during scheduled work hours is required.

Requirements

• High school diploma or GED.
• One year of customer service experience, or an equivalent combination of education and experience.
• Knowledge of medical terminology.
• Understanding of claims management.
• Excellent oral and written communication skills.
• Computer proficiency, including Microsoft Office products.
• Strong organizational skills.
• Good interpersonal skills.
• Ability to multitask in a fast-paced environment.
• Ability to support multiple clients across communication channels and use multiple systems simultaneously.
• Ability to work in a team environment and/or independently.
• Ability to meet or exceed Performance Competencies.

Nice To Haves

• College courses.
• Inbound call center experience.

Responsibilities

• Serve as the primary liaison with callers and follow client specifications to answer questions and resolve problems related to claims application and servicing processes.
• Educate customers through multiple communication channels about required claim documentation, time frames, payment information, and claim status.
• Explain client requirements and benefit plans to claimants and callers, documenting all required call details concisely and professionally.
• Accurately enter verbal and written application information into the claims management system to meet internal and external customer requirements.
• Assign new claims to the appropriate claims handler.
• Direct customer calls to the appropriate contact at multiple locations or escalate them to a Service Center Specialist or management as needed.
• Attend work during scheduled work hours.
• Support the organization's quality programs.
• Perform other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED