Patient Care Representative

Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive.A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work.Great Place to Work®Most Loved Workplace®Forbes Best-in-State EmployerPatient Care RepresentativePRIMARY PURPOSE : To service patient caseload and provide customer service support to clients arranging medical services or products provided to workers’ compensation patients; to support manager with new hire training, development, hiring, and daily functions.ESSENTIAL FUNCTIONS and RESPONSIBILITIES

Proactively communicates with patients in relation to new or already processing referrals confirming patient demographic information, providing updates on the referral, and/or confirming delivery of goods or service.

Liaises 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.

Communicates with internal and external clients on existing referrals, new referrals, or other team members referrals.

Provides quotes 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 claim’s adjuster; processes referrals per state regulations and workers compensation guidelines.

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.

Acts as a mentor and resource for team members; provides help and support to patient care coordinators. Fosters and encourages a team environment through collaborative problem-solving and direct coaching.

Executes direct training efforts related to weekly new hire training benchmarks throughout hire’s introductory training period. Keeps team leader updated on new hire’s training completion progress; proactively communicate observed trends, concerns, and developmental progress around individual level new hire training to team lead.

Takes part in candidate interview process and provides feedback, serves as shadowing host for candidate interviews, and observes and evaluates level of candidate engagement.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

Performs other duties as assigned.

Travels as required.

QUALIFICATIONSEducation & LicensingHigh school diploma or GED required. Associate’s degree preferred.ExperienceThree (3) years of related experience in healthcare network and patient care scheduling or equivalent combination of education and experience required.Skills & Knowledge

Excellent oral and written communication skills

PC literate, including Microsoft Office products

Analytical and interpretive skills

Strong organizational skills

Excellent interpersonal skills

Strong negotiating skills

Ability to work in a team environment

Ability to meet or exceed Performance Competencies

Strong problem-solving skills

WORK 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 talkingThe 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 - $21.00) . 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.Taking care of people is at the heart of everything we do. Caring countsSedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing – one where caring counts. Watch this video to learn more about us. (https://www.youtube.com/watch?v=ywxedjBGSfA)