Referral Coordinator

In this job, you will:

• Manage and/or assign files to appropriate staff members and initiate appropriate verbal and/or written contacts with employers, clients, claimants, and medical providers.
• Set up files in all appropriate systems; assign files, when applicable, to the nurse
• Facilitate and schedule appointments as needed, and keep the Telephonic Nurse Case Manager (TCM), clients, claimants, providers, and employers informed verbally and/or in writing of any changes, delays, updates, or problems
• Maintain appropriate electronic and paper files
• Obtain authorization for medical release of information from the adjuster, as necessary, for records acquisition
• Interface with a variety of inter-disciplinary providers (e.g., PT, diagnostic, psychology, etc.)
• Identify, maintain, and update participating providers
• Utilize Share Point tool for evaluating case risk, and input all activities (including verbal and written discussions) into the Ultimate database and customer/client system
• Answer incoming calls, and direct the call appropriately
• Process all documents using computer, copier, and scanner
• Search and copy the appropriate internal criteria guidelines, when appropriate
• Screen all re-open files (subsequent URs) to determine duplicate requests, vs. an appeal request that is beyond the allotted timeframe, vs. a reconsideration, vs. a new UR
• Basic invoicing
• Continually improve job skills and knowledge of all company products and services as well as customer issues and needs, through ongoing training and self-directed research.
• Adhere to company policies, procedures, and reporting requirements.

• Experience in any of the following disciplines a plus – CNA, Medical Assistant, Physical Therapy Aide, Workers’ Compensation, Medical Unit Claims Administrator, IME Coordinator, Medical Office Manager
• Experience with workers' compensation or disability (a plus!)
• Strong computer and internet skills (will work with programs including MS Word, Outlook, and Excel)
• Basic knowledge of/ability to read medical reports, or enthusiastic about learning medical terminology
• The ability to research evidence-based guidelines
• Proficient verbal/telephone and written communication skills
• A high level of efficiency, ability to maintain rapid workflow
• An aptitude for learning, organization skills and the ability to follow systems and procedures
• A time-management mindset, along with planning, and prioritization skills
• The ability to multi-task in a fast-paced environment
• The ability to work independently as well as part of a team
• The ability to express empathy with injured and/or disabled people
• Deductive reasoning and think outside the box for creative solutions
• Independent thinking & problem-solving experience
• A bachelor’s degree, or an Associate's/Certification with professional experience
• A customer service mindset