Job description

State and Federal Worker’ Compensation and Motor Vehicle Cases

As an adjuster or WC/MVA Case Manager you will be in charge of managing and fostering the relationships between the employer/adjuster/nurse case manager/attorney, funding companies and the provider. Ensuring patients remain educated about their care plan and that they maintain compliance throughout the care plan. Providing timely communication and documentation to all parties involved in the process. Especially the referral source. your goal on the administrative side of the practice is to "Take the WORK out of Workers' Compensation" for the employer/adjuster/nurse case manager/attorney. We want to be so good that they do not know how they did things before we began working with them.

Position Summary

Handling incoming and outgoing referrals for state, federal, MVA

Requesting PAs for State comp, Fed Comp and Funding companies

Submitting certified liens for MVA cases

Inputting demographic and payer info

Screening and intake on federal comp and MVA

Initial intake

Communicating off site approvals/billing/coding and collection department

Drafting letters for federal workers comp

Handing all paperwork related to state, federal workers’ comp and MVAs

Tracking referral sources, tracking stats on referrals by referral sources each month and setting up meetings with ownership and referral sources when possible to meet to further expand their Core Medical Centers relationship

Navigating various insurance websites and ECOMP sites to upload proper documentation when necessary for submitting records or other pertinent paperwork specific to each case type.

Keep track of all cases using the specific systems used by CMC to track cases and KPIs

Submitting records within 24hrs of completed visit.

Being a constant communication employer/adjuster/nurse case manager on status and progress of the injured worker.

Nurturing relationships between employer/adjuster/nurse case manager and CMC/ownership.

Handling intake on all comp and MVA exams and inputting into EHR along with Provider orders and plan of care and entering CPT codes and ICD-10 codes as instructed

Setting up and participating in meet ups with the owner and employer/adjuster/nurse case manager/attorney and funding company leadership to enhance relationships with referral sources.

Communicate and respond to funding companies and submitting bids for care based on providers' written care plan and fee schedule.

Seeking out networks and requesting contracts to join other comp networks we are not in yet or setting up meetings so ownership can negotiate contracts.

PERFORMANCE OBJECTIVES

• Timely submission and responses to all referrals, employers, adjusters, nurse case managers and attorneys.
• Make patients feel respected and cared for while following best practices to provide high quality care and while ethically balancing directives for care by referral source.
• Follow Core Medical Center Standard of Care Guidelines and report any staff or provider not adhering to these guidelines.
• Ensure patients are scheduled for all visits, makes ups and PAs are submitted and completed so that care can be delivered.
• Each case is completed and all documents are submitted to the appropriate source in a timely manner and all loose ends are followed up on and completed prior to closing the case.

Capabilities/Key Competencies:

• Excellent relationship building skills with a demonstrated ability to quickly develop trust
• Ability to make decisions, offer strong recommendations, and take responsibility for results
• Self-starter who can work independently within existing processes or operate effectively with ambiguity
• Strong oral and written communication skills
• Planning, organizing, prioritizing, and streamlining skills
• Ability to maximize internal systems, processes, and platforms
• Team orientation and strong collaborator
• Present self in a professional and positive manner in attitude and appearance at all times
• Able to coordinate and balance needs of the patient and the clinic
• Understand, align, and communicate to staff our mission, vision, and values
• Desire to define and take massive action to accomplish your own personal, professional and financial goal

About Core Medical Center

Mission: Our mission is to provide the most comprehensive multi-specialty care to improve or enhance our patient’s ability to function and provide long term results that will allow our patients to enjoy life.

Vision: Core Medical Center will be known across the Midwest as a leader in comprehensive multi-specialty care including physical medicine, procedural medicine, occupational medicine, behavioral health and primary care/walk-in facilities along with ASC facilities.

OTHER DUTIES

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice

Commitment to Diversity:

As an equal opportunity employer committed to meeting the needs of a multigenerational and multicultural workforce, Core Medical Center recognizes that a diverse staff, reflective of our community, is an integral and welcome part of a successful and ethical business, we hire local talent at all levels regardless of race, color, religion, age, national origin, gender, gender identity, sexual orientation, or disability, and actively foster inclusion in all forms both within our company and across interactions with clients, candidates and partners.

Job Type: Full-time

Pay: $49,920.00 - $58,240.00 per year

Benefits:

• 401(k) matching
• Dental insurance
• Flexible schedule
• Health insurance
• Paid time off

Schedule:

• Monday to Friday

Ability to commute/relocate:

• Blue Springs, MO 64015: Reliably commute or planning to relocate before starting work (Required)

Experience:

• Workers' Compensation: 2 years (Preferred)

Work Location: In person

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