Principal Duties and Responsibilities (Essential Functions): ⢠Triage injury/illness calls to determine if emergent/non-emergent ⢠Determine if injury/illness requires immediate treatment or first aid advice ⢠Research/locate the nearest facility to utilize for injury ⢠Contact medical facility to determine the availability of adequate services to meet the needs of the particular injury/illness ⢠Coordination of visit via phone/fax ⢠Speak with Medical personnel regarding the mechanism of injury/illness and discuss appropriate treatment pathways, obtaining UDS and BAT when applicable, and workplace accommodation availability ⢠Inform client/injured worker of name/location and contact information of medical facility available ⢠Notify appropriate contacts via email of injury/illness details with initial information within one hour of notification, unless an extreme situation ⢠Provide updates of diagnosis, work status, plan of care and follow up appointments to appropriate personnel with injured worker's employer and adjuster ⢠Provide updates, diagnosis, clinic notes and treatment authorization requests to designated representative for client and Worker's Compensation insurance adjuster ⢠Log injury/illness details on spreadsheet; Client specific ⢠Enter injured worker, adjuster name and claim number into Billing Portal to apply billing time and status of case as it occurs ⢠Bill time for each case according to services rendered ⢠Field Case Management services for client/injured worker needing onsite Case Management services at the time of visit. This includes communicating directly with the provider and obtaining pertinent paperwork at the visit ⢠Generating letters to providers, for clarification of work-relatedness and or treatment plan ⢠Obtaining and reviewing Medical records and diagnostics with relation to present injury/illness, prior history and/or forwarding to Specialty providers when allocated ⢠Proper documentation of phone calls made and received, interpretation of medical records from each exam, work status, and all emails transpired with regard to each case ⢠Coordinate SMO's with specialists as needed ⢠Coordinate FCE's to determine job capabilities ⢠Rotate Call to ensure 24/7/365 CM services; perform duties as stated above for calls received ⢠Transfer phone lines every morning and evening for phone coverage 24 hrs a day ⢠Assist Upper Management in CM activities as requested ⢠Answer phones in a professional manner when receptionist is not available ⢠Attend and participate in staff meetings ⢠Assists in office related tasks as needed ⢠Participate in opportunities for learning and skill maintenance/development, including internal and external training and workshops.