Medical Case Manager, No Medical Experience Needed

hace 8 horas


San José, Costa Rica In The Network Llc A tiempo completo

Summary   Serves as In The Network (ITN) injured party's advocate in the healthcare and legal environments intertwined in the personal injury process.
Manage the well-being of assigned clients and guide them through all the details and processes related to their cases.
Responsible for providing invaluable support to attorneys and their staff by overseeing case files, managing caseload requirements, and providing oversight of case billings, budgets, and timelines.
Must be able to communicate effectively and use available resources to promote health, quality, and cost-effective outcomes.
COMPANY WILL BE RESPONSIBLE FOR TRAINING, TRAINING IS PAID.
  Duties and Responsibilities Open new client files by entering them into the case management app/software.  Communicate with clients to ensure timely and effective information sharing regarding upcoming appointments, deadlines, and other aspects of their cases.
 When necessary, arrange transportation to get clients to and from medical treatments.
 Must be empathetic and compassionate to relate to the injured person and understand all the difficulties they are experiencing.  Direct clients to your law firm counterparts to allow clients to follow up with legal claims status and communicate with insurance companies, medical providers, and the legal team.   Organization skills allowing for accurate follow-up and keeping clients to the prescribed schedule of appointments and treatments necessary for each case.
 Manage medical requests and treatment plans.  General knowledge of policies with the ability to obtain policy limits.
 Gather and confirm receipt of all required documents, forms, and authorizations.
 Follow case direction requests of Client Case Manager Auditors and Law Firms.
 Communicate with Client Case Manager Auditors on important issues and correct deficiencies identified during audits and file reviews.
 Order medical records and other required records to process claims.   Obtain photographs of injuries and scenes, if applicable.
 Track and create reports.   FOIA all necessary documents, videos, and other materials.
• Adhere to all app/software written policies and procedures.  Meet and exceed Key Performance Indicators (KPIs).
 Collaborate and cooperate with other staff members as requested.   Demonstrate a willingness to take on new tasks with a good attitude.
• Attends company-wide meetings as scheduled.
Skills and Qualifications   Deep knowledge and experience in navigating the many aspects of the healthcare and legal processes involved in personal injury.   Knowledge of medical records and legal documents with working knowledge of HIPAA   practices.
 Strong follow-up and organizational skills with precision in gathering, organizing, and filing documents.   Independent thinker who possesses the ability to follow instructions.   Ability to work effectively within a team-oriented work environment.   Excellent written and verbal communication   Excellent interpersonal and customer service skills, with the ability to be personable during phone interactions with clients, attorneys, and experts.  Ability to follow instructions and give close attention to detail.
 Ability to prioritize tasks and delegate when appropriate.  Strong personal focus on meeting or exceeding individual, department, and client goals.  Willingness to learn and become proficient in new software and technologies   Physical Requirements   Stand or Sit: Must remain stationary 50% of the time.  Walk: Must be able to move inside the office to access cabinets, machinery, etc.  Use hands/fingers to handle or feel: Constantly operate a computer and other office productivity machinery, such as a copy machine, computer, and printer.
Stoop, kneel, crouch, or crawl: Constantly positions self to provide service for machinery, computers, printers, etc.
Talk/hear: The ability to communicate information and ideas so others will understand.
Must be able to exchange accurate information in these situations.  See: The ability to observe details at close range (within a few feet of the observer).
Carry weight, lift: Frequently moves boxes weighing up to 20 pounds across the office for various needs unassisted, 25 pounds heavier with assistance.
Exposure to work: Exposure to normal office conditions.
Quick Response: Must be able to respond quickly to sounds.
  Physical Requirements BS/BA in Business is preferred, and/ or equivalent experience can be substituted on a year-per-year basis.  High School Diploma required.  Paralegal certificate desired.
At least two years of legal case management experience preferred.  Insurance industry experience preferred.  Proficient with Microsoft Office Suite or related software and email  Strong typing skills.  Must communicate (orally and written) effectively in English; Bilingual is a requirement.
English level C1 OR ABOVE IS A MUST.
  You must be able to perform the essential functions of the position satisfactorily, and if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions of their job, absent undue hardship.
The Employer retains the right to change or assign other duties to this position.


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