At York, we believe that an experience marked by expertise, consistency and compassion sets us apart. And we celebrate the diverse backgrounds and unique perspectives that allow us to stand apart from our competitors. Thats why we are committed to recruiting, developing and retaining people who represent our values and who believe in our mission.

Job Description

• Provide medical guidance and support to a team of Case Specialists in accordance with Company and BWC policies and procedures
• Evaluate, authorize and deny treatment authorization requests in accordance with Company and BWC policies and procedures
• Facilitate RTW and medical issues between employers, providers, Third Party Administrators and Case Specialists, as needed
• Audit treatment authorization requests for Case Specialists to ensure accuracy and timeliness in accordance with Company and BWC policies and procedures
• Staff treatment authorization requests with Physician Advisor staff per company policy
• Be fully prepared to transfer to Case Manager role when caseloads exceed established URAC standard
• Assistance with Case Specialist caseload reviews, as needed, for claims management direction
• Ongoing training to Case Specialists
• Assist with Performance Evaluations from a treatment standpoint
• Backup to other CRRs
• Availability to train new CRRs

Required Skills:

• Ability to demonstrate knowledge of current treatment practices and protocols
• Familiarity with workers compensation rules and policies preferred
• Excellent interpersonal, communication, problem solving and computer skills