York Risk Services Group is a premier provider of insurance, risk management, alternative risk, pool administration and claims management solutions to clients across hundreds of industries. Recently named by Forbes as one of "America's Best Midsized Companies Two Years in a Row" We firmly believe that our employees drive the success of the company. With success in mind as the ultimate goal, we strive to create and provide an environment that offers challenging, stimulating and financially rewarding opportunities.

Job Description

ESSENTIAL JOB RESPONSIBILITIES:

• Confirm introduction letter sent to injured worker and log activity for the letter and the file set-up fee, if applicable
• Send professional courtesy letter to attorney, if applicable
• Send appointment reminder letters to the injured worker
• Update the Provider Detail tab in CareLink
• Update the Work Status tab in CareLink
• Update the Cost Savings/AWW tab in CareLink
• Request medical documents from appropriate providers
• Assure medical documents are received after MD or diagnostics appointments. Notify the Nurse Case Manager once received for their review
• Disseminate faxes to Nurse Case Managers in a timely manner
• Support field Nurse Case Managers, i.e. obtain medical records, claim file detail, communicate UR Coordinator information and available to answer email, calls and faxes
• Obtain medical reports and required work status forms
• Ensures all parties receive appropriate reports/documents
• Contact the injured worker with follow up calls regarding appointments. The initial phone call to the injured worker is performed by the Nurse Case Manager
• Confirm receipt of authorizations, medical records received from the provider offices, and medical records have been received in the provider offices.
• Order approved DME through appropriate vendors or York Portal at the direction of the Nurse Case Manager
• Coordinate approved rehabilitation services such as physical therapy, occupational therapy, speech therapy, home health services and transportation at the direction of the Nurse Case Manager
• Copy, fax and/or e-mail medical records to appropriate offices when requested
• Obtain all past medical records if directed
• Arrange for prompt and appropriate medical treatment of an injured worker at the direction of the Nurse Case Manager. Facilitates authorization/certification of procedures, diagnostic testing, physical therapy/occupational therapy and durable medical equipment as per regulations to ensure appropriate treatment is not delayed
• Copy records and completes necessary referral forms for RURs and IRRs when appropriate
• Complete other tasks as requested by the Nurse Case Manager to facilitate the movement of the file as long as the request is supported by administration/management