Rising Medical Solutions Claims Assistant - Entry-Level Healthcare Administrative Role in Chicago, Illinois
Are you a new graduate with a major in the health sciences and/or someone who is excited about learning more about cost containment and medical aspects of the Workers’ Compensation field? Do you enjoy a fast-paced environment with many moving parts? Are you looking to transition from a clinical environment to a more corporate/office environment? If you answered yes to the questions above, please keep reading to learn more about our Injury Coordinator (working title: Workers' Compensation Claims Representative) opportunity!
In this role, you will:
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.
Search and copy the appropriate internal criteria guidelines, when appropriate.
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.
Adhere to company policies, procedures, and reporting requirements.
1+ year of experience in a healthcare or insurance setting OR a Certificate, Diploma, Associate's Degree, or Bachelor's Degree in a health-related area (examples including but not limited to: kinesiology, healthcare administration, medical assistant, biology, physical therapy assistant, occupational therapy assistant, medical office assistant, nursing assistant, medical office manager)
Independent thinking & problem-solving abilities
Strong computer and internet skills (will work with programs including MS Word, Outlook, Excel, and internal software programs)
Basic knowledge of/ability to read medical reports, familiarity with medical terminology
The ability to research evidence-based guidelines
Proficient verbal/telephone and written communication skills
An aptitude for learning, organization skills and the ability to follow systems and procedures
The ability to multi-task in a fast-paced environment
The ability to express empathy with injured and/or disabled people
Deductive reasoning and think outside the box for creative solutions
A relaxed, yet upbeat work environment, with a jeans professional dress code
Beer, soft drinks, and snacks on Friday afternoons
Competitive salary, 401k matching, paid time off, and career growth opportunities.
Vibrant downtown location in River North, close to public transit