Care Coordinator

Care Coordinators facilitate care management and utilization review by performing data collection & data entry, and effectively communicating with Nurse Case Reviewers/Managers, employers and claimants in regards to claimants’ workers’ compensation cases.

Requirements

• Collect data from claimant representative, physician, or hospital; verify claimant case status and provider network status.
• Set up cases in system in accordance with departmental workflows, policies and procedures.
• Assist Nurse Case Reviewers with non-clinical issues tasks such as requesting clinical information from providers, obtaining necessary forms, and confirming work status.
• Enter required case demographics and transcribe clinical information
• Handle incoming group phone calls and interact with employers, employees, physicians and insurance adjusters to gather information about medical status, and/or type of care needed in a timely manner.
• Schedule medical appointments for members with in-network facilities and providers and coordinate/verify member attendance at the appointment.
• Maintain and update all activity trackers within designated timeframes.
• Verify and ensure the accuracy of claimant cases; create, scan, fax, mail, and upload correspondence and documentation as needed.
• Follow established quality assurance standards and all policies and procedures.
• Report and document any concerns, complaints and/or issues with direct supervisor.
• Demonstrates a kind, caring, sympathetic and positive attitude with all customers and fellow employees.
• Perform Ad-Hoc projects and support departmental initiatives as needed.