Ohio

Analyst Claims Administration I (Hourly)

Job description          

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. That’s why we are committed to recruiting, developing and retaining people who represent our values and who believe in our mission. Job Description Skills/Qualifications: · Associates or Bachelor’s Degree, or equivalent work experience in workers’ compensation, health care, insurance, rehabilitation, sports medicine, or claims management · One to three years’ experience in a similar position · One year (minimum) demonstrated experience as CareWorks Case Specialist preferred · Ability to maintain a fast-paced, multi-task oriented schedule · Positive attitude and demonstrated flexibility · Excellent customer service, communication, organizational, time management, problem solving, critical thinking and computer skills · Familiarity with workers’ compensation rules and policies, specifically knowledge of BWC Chapter 4 guidelines for voc rehab contract performance expectations for vocational rehabilitation services preferred Duties: · Maintain customer satisfaction by serving as Vocational Rehab/Remain At Work contact for designated group of employers to ensure customer satisfaction and retention · Maintain compliance with BWC Vocational Rehab Policies, BWC Vocational Rehab Fee Schedule, Company Policies and MCO contract requirements Support vocational rehab services: o Enter data and maintain timely updates of information into Conduit system completing EDI updates to BWC as required by policy o Identify and review cases to ensure eligibility for BWC surplus fund services o Request BWC “readiness and eligibility” o Serve as liaison between company and BWC rehabilitation representatives on eligibility issues o Maintain database on efforts to ensure follow up on eligibility/feasibility issues o Identify and review cases to ensure eligibility for BWC surplus fund services and perform detailed review of vocational rehab plans and closure information o Collaborate with vocational rehabilitation case managers and BWC rehabilitation representatives related to services, reimbursement and compliance o Process C-9s according to CareWorks’ C-9 Scope of Processing o Refer cases for case management (CM) triage / services based Company Policies and Procedures o Gathering BWC RTW strategy information o Update Case Status in accordance with Company policies and procedures o Monitor and document provider progress notes to ensure compliance with Company and BWC Policies and Procedures and injured workers’ progress o Verify return to work or remain at work follow up and treatment plan based on Vocational Rehab Plan services · Evaluate and perform data management tasks associated with validating the integrity and consistency of Conduit/BWC, Vocational Rehabilitation data · Adhere to established Company and BWC Policies and Procedures · Maintain confidentiality as established by Company and URAC guidelines · Achieve established performance standards for Vocational Rehabilitation · Identify areas for quality improvement and make recommendations to manager · Work in a team environment Attachments
York Risk Services Group Ohio jobs

York Risk Services Group

Ohio jobs

Ohio jobs

 Ohio jobs  Ohio jobs

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York Risk Services Group Ohio jobs

York Risk Services Group (Ohio jobs)

 Jobs in organization(state)

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 f...

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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 f...

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