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The Report Specialists support our Telephonic Triage service by processing calls and generating reports from supervisors or injured workers that do not require injury triage, yet fulfill client reporting requirements.
Essential Duties and Responsibilities:
Posted 3 months ago
The Nurse Specialist reports to the disability case manager and is responsible for managing short term disability claims for contracted clients from intake through approval for payment, continued monitoring of open claims and clerical functions to support these services. Main Duties and Responsibilities:Access claims submissions via fax and email, review for required information in compliance with client policies, accurate data entry, and communicate to client representative for paymentMaking decisions for approval or denial of claims using contractual, medical, and vocational analysisMaintain productive relationships with internal advocates, client employees and benefits representatives, and medical professionalsRespond in timely manner to high volumes of written (fax and email) and verbal (primarily telephone) communication with a wide range clients’ employee, client representatives, medical professionals in multiple communitiesContinual prioritization of conflicting demands with rapid response and efficient resolution.Frequent communication with internal team membersEnsure a high level of client satisfaction, meeting weekly reporting requirements and quick turnaround times for claims processingAssume the daily functions for the Disability Claims Manger when absent, whether planned or unexpected