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Injury Coordinator - Remote

Company: Rising Medical Solutions
Location: Kansas City
Posted on: November 25, 2022

Job Description:

The Injury Coordinator is responsible for coordinating and managing a range of health care related services such as, communicating with patients, providers, adjusters, etc. to determine appropriate treatment, and to secure a timely return to work status for the injured workers.------ Core Responsibilities include:

  • Manage and/or assign files to appropriate staff member and initiate appropriate verbal and/or written contacts with employers, clients, claimants, and medical providers.
  • Set up files in all appropriate systems; assign files, when applicable, to the nurse.
  • Maintain responsibility of an individual caseload
  • Facilitate and schedule appointments as needed and keep the Telephonic Nurse Case Manager (TCM), clients, claimants, providers, and employers informed verbally and/or in writing of any changes, delays, updates, or problems.
  • Maintain appropriate electronic and paper files.
  • Obtain authorization for medical release of information from the adjuster, as necessary, for records acquisition.
  • Provide care direction as necessary.
  • Interface with a variety of inter-disciplinary providers (e.g., PT, diagnostic, psychology, etc.).
  • Identify, maintain, and update participating providers.
  • Utilize Triage scoring tool for evaluating case risk and input all activities (including verbal and written discussions) into the Ultimate database and customer/client system.
  • Answer incoming calls and direct the call appropriately.
  • Process all documents using computer, copier, and scanner.
  • Search and copy the appropriate internal criteria guidelines, when appropriate.
  • Screen all re-open files (subsequent URs) to determine duplicate requests, vs. an appeal request that is beyond the allotted time-frame, vs. a reconsideration, vs. a new UR.
  • Work as part of a team to meet turn-around time for the set activity.
  • Keep supervisor advised of any problems or delays.
  • Continually improve job skills and knowledge of all company products and services as well as customer issues and needs, through ongoing training and self-directed research.
  • Provide customer service in English and Spanish
  • Adhere to company policies, procedures, and reporting requirements. ------ Reports to:
    • Injury Coordinator Team Lead
    • Technical Manager ------ Requirements/Education:
      • Experience in any of the following disciplines a plus - CNA, Medical Office Manager, Medical Assistant, Physical Therapy Aide, Workers' Compensation/Medical Unit Claims Administrator, IME Coordinator
      • Experience with workers' compensation or disability (a plus!)
      • Intermediate computer and internet skills (will work with programs including MS Word, Outlook, and Excel)
      • Basic knowledge of/ability to read medical reports
      • The ability to research evidence-based guidelines
      • An understanding of workflow guidelines and follow as necessary
      • Proficient verbal/telephone and written communication skills
      • A high level of efficiency, ability to maintain rapid workflow
      • An aptitude for learning, organization skills and the ability to follow systems and procedures
      • A time-management mindset, along with planning, and prioritization skills
      • The ability to multi-task in a fast-paced environment
      • The ability to work independently as well as part of a team
      • The ability to express empathy with injured and/or disabled people
      • A customer service mindset------ Working Conditions:
        • Remaining in a seated position
        • Entering text or data into a computer
        • Visual Acuity
        • Talking
        • Hearing
        • Repetitive arm, hand, finger motion
        • Working remotely some or all the time ------ Risings Benefits:
          • Health insurance (4 different plans to choose from)
          • Dental
          • Vision
          • Paid time off (PTO) or Flexible Time Off (FTO)
          • 401(k)
          • Basic Life Insurance and Long-Term Disability Insurance (paid by the company)
          • Voluntary Life Insurance and Short-Term Disability Insurance
          • Flexible Spending Accounts (FSA)
          • Employee Assistance Program (EAP)
          • Rise Well Wellness Program
          • Professional Development Reimbursement Program (PDRP)
          • You will be part of our new Elevate program designed to recognize and reward employees for their hard work ------ About Us: Headquartered in Chicago, RISING Medical Solutions is a privately held, financial solutions organization offering medical cost containment and care management services. With offices, providers, and case managers nationwide, RISING provides comprehensive medical claims solutions to our valued clients: insurance carriers, Fortune 1000 employers, third party administrators, and government organizations. At RISING, we're committed to:
            • Continuous technological improvement
            • Entrepreneurial attitude
            • Seven core values that emphasize teamwork, ethical behavior, customer service, continual improvement, positive attitude, focusing on what's important, and keeping a sense of humor
            • Responding quickly to client needs
            • Being the best, not the biggest

Keywords: Rising Medical Solutions, Kansas City , Injury Coordinator - Remote, Other , Kansas City, Kansas

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