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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.

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

Benefits

  • 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

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