Case Management Associate

To access and assign workers compensation, disability and liability cases applying current policies and procedures per state workers compensation laws; and to increase efficiency of operation by providing general customer support duties and supporting the medical staff in a team environment.

ESSENTIAL RESPONSIBLITIES MAY INCLUDE

Accesses and assigns cases for medical case management, utilization review and clinical consultation.

Provides accurate information to callers based on customer requests; triages telephone calls between utilization review, clinical consultation and telephonic case managers.

Enters new claims data into the claims management system accurately; maintains data integrity.

Supports clinical staff through the completion of components of the case management and utilization review process.

Schedules diagnostic tests and physician appointments as assigned.

Provides channeling services for injured workers, employers and claims examiners by directing into PPO network for treatment.

Gathers statistics for record keeping and provides reports as required.

Ensures by confirmation that fax forms and filings required by regulatory agencies have been received; distributes, faxes, mails and copies incoming and outgoing correspondence.

QUALIFICATIONS

Education & Licensing: Associate's degree or two (2) years of college preferred.

Experience: One (1) year of administrative experience required. Customer service experience in a medical field preferred. Worker's compensation, disability and/or liability claims processing experience preferred.

Flexible work schedule.

Referral incentive program.

Opportunity to work in an agile environment.

Career development and promotional growth opportunities.