Job Description
Job Summary Project management/coordination of claimant cases assigned by third parties (contracted companies, attorneys, case managers, worker's compensation board, etc.) including scheduling exams, invoicing Independent Medical Evaluation's (IME's) and record reviews, procuring payment, document/medical record retrieval, document/medical record summary and organization, coordinating with physicians to complete tasks and quality control/editing of reports. Creating new business connections and maintaining current third-party relationships.
Essential Functions - Schedules claimant appointments and confirms no conflict of interest for IME's.
- Sends out invoices for IME's and Record Reviews and follows up to ensure payment is received in a timely manner.
- Multi-tasking and handling diverse and complex claim cases including worker's compensation claims, automobile accidents, personal injury, and short and long term disability.
- Obtain legal documents and medical records, summarize medical records, organize and prepare records to be delivered to physician for review.
- Preps IME's, peer reviews and record reviews including recording, reviewing and appropriate summary information. Prep, print, organizes and delivers physical copies of all paperwork to the physicians in a timely manner.
- Understands medical terminology to assist clients and physicians.
- Obtain multiple dictations and compile reports, obtaining physician's signature, and sending out final reports to parties involved ensuring the standard of quality remains high before being distributed.
- Interact closely with physician to manage completion of each task.
- Knowledgeable of Work Comp, Automobile, disability, and Personal Injury Claims.
- Knowledgeable of Physician protocols, IME's, record reviews and peer reviews.
- Maintains strict confidentiality required related to medical records and other data.
- Participates in professional development efforts to ensure currency in health care practices and trends.
- Aid in securing new business opportunities and connections.
- Use organizational skills to create processes that assist in more efficient project management and obtaining additional clients.
- Create and distribute marketing materials working with Marketing and Outreach Manager.
- Other duties as assigned.
Skills and Abilities - Ability to communicate clearly and professionally, possessing excellent phone skills in order to establish/maintain trust of current clients (third party vendors, attorneys, insurance companies).
- Needs to maintain a cooperative relationship with patients, physicians, and staff.
- Must be able to efficiently gather insurance and/or account information.
- Must be able to navigate and comprehend computer software systems in an office setting, prefer 50 wpm.
- Must maintain knowledge of clinic, insurance contract policies and procedures and medical terminology as related diverse claims.
Physical and Mental Demands - Able to sit for up to 8 or more hours/day while doing computer input and responding to phone questions.
- Work requires high speed and a degree of accuracy.
- Must be able to view computer screens for long periods and have manual dexterity using keyboard.
- Performs complex tasks requiring independent judgement, exercising discretion.
- Able to handle difficult and sensitive information related to claims and dealing with dissatisfied physicians or clients.
The job holder must demonstrate current competencies applicable to job position.
Environmental Work Conditions Office setting with minimal exposure to communicable diseases.
Standard Qualifications Education: High school diploma or equivalent required.Additional certification or related educational experience preferred.
Experience: Minimum cumulative of three years of experience in workers compensation, medical chart review and/or medical records
This description is intended to provide guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities, and working conditions may evolve as needs change.
The job holder must demonstrate current competencies applicable to the job position.
Ascendant Orthopedic Alliance, LLC dba South Bend Orthopedics (SBO) has the right to revise this job description at any time. OrthoAlliance
Job Tags
Contract work, Temporary work,