Injury Coordinator - Remote
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.
- Injury Coordinator Team Lead
- Technical Manager
- 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
- Remaining in a seated position
- Entering text or data into a computer
- Visual Acuity
- Repetitive arm, hand, finger motion
- Working remotely some or all the time
- Health insurance (4 different plans to choose from)
- Paid time off (PTO) or Flexible Time Off (FTO)
- 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
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
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