Care Coordinator ( State and Federal Worker’ Compensation and Motor Vehicle Cases)

As a care coordinator you will be in charge of managing the relationships between the employer/adjuster/nurse case manager/attorney, funding companies and the provider. Ensuring patients remain educated about their care plan and that they maintain compliance throughout the care plan.

Position Summary

Handling incoming and outgoing referrals for state, federal, MVA

Requesting PAs for State comp

Submitting certified liens for MVA cases

Inputting demographic and payer info

Screening and intake on federal comp and MVA

Initial intake on state comp

Sending PA requests for Federal Workers’ comp to off site approvals/billing/coding and collection department

Drafting letters for federal workers comp

Handing all paperwork related to state, federal workers’ comp and MVAs

Tracking referral sources, tracking stats on referrals sent by each each month and setting up meetings with ownership and referral sources when possible to meet to further expand their Core Medical Centers relationship

Navigating various insurance websites and ECOMP sites to upload proper documentation when necessary for submitting records or other pertinent paperwork specific to each case type.

Keep track of all cases using the specific systems used by CMC to track cases and KPIs

Submitting records within 24hrs of completed visit.

Being a constant communication employer/adjuster/nurse case manager on status and progress of the injured worker.

Nurturing relationships between employer/adjuster/nurse case manager and CMC/ownership.

Handling intake on all comp and MVA exams and inputting into EHR along with Provider orders and plan of care and entering CPT codes and ICD-10 codes as instructed

Setting up and participating in meet ups with the owner and employer/adjuster/nurse case manager/attorney and funding company leadership to enhance relationships with referral sources.

Communicate and respond to funding companies and submitting bids for care based on providers' written care plan and fee schedule.

Seeking out networks and requesting contracts to join other comp networks we are not in yet or setting up meetings so ownership can negotiate contracts.

PERFORMANCE OBJECTIVES

• Timely submission and responses to all referrals, employers, adjusters, nurse case managers and attorneys.
• Make patients feel respected and cared for while following best practices to provide high quality care and while ethically balancing directives for care by referral source.
• Follow Core Medical Center Standard of Care Guidelines and report any staff or provider not adhering to these guidelines.
• Ensure patients are scheduled for all visits, makes ups and PAs are submitted and completed so that care can be delivered.
• Each case is completed and all documents are submitted to the appropriate source in a timely manner and all loose ends are followed up on and completed prior to closing the case.

Capabilities/Key Competencies:

• Excellent relationship building skills with a demonstrated ability to quickly develop trust
• Ability to make decisions, offer strong recommendations, and take responsibility for results
• Self-starter who can work independently within existing processes or operate effectively with ambiguity
• Strong oral and written communication skills
• Planning, organizing, prioritizing, and streamlining skills
• Ability to maximize internal systems, processes, and platforms
• Team orientation and strong collaborator
• Present self in a professional and positive manner in attitude and appearance at all times
• Able to coordinate and balance needs of the patient and the clinic
• Understand, align, and communicate to staff our mission, vision, and values
• Desire to define and take massive action to accomplish your own personal, professional and financial goal

About Core Medical Center

Mission: Our mission is to provide the most comprehensive multi-specialty care to improve or enhance our patient’s ability to function and provide long term results that will allow our patients to enjoy life.

Vision: Core Medical Center will be known across the Midwest as a leader in comprehensive multi-specialty care including physical medicine, procedural medicine, occupational medicine, behavioral health and primary care/walk-in facilities along with ASC facilities.

Core Values:

Processes – our staff follow the policies and procedures that have been approved. Written documentation to update policies to replicate successful actions and to eliminate those that do not. If something could be improved, it must be documented and improve our process so that we can replicate successful actions and eliminate unsuccessful ones. We educate the patients on them so that they will understand the process and with a high level of satisfaction.

Innovation---- we constantly strive to enhance patient care and use the latest and proven methods to treat outpatients. We are always looking for ways to enhance the patient experience and reach our goals. Using the standard of care guidelines and adding to them as approved by ownership.

Service---- above all we work to service our patients and we see it as our duty to provide them with the best patient experience possible. High level of service leads to goal attainment.

Accountability---- We hold ourselves; we hold each other, and we hold our patients to be responsible for actions that must be taken in the process of achieving the patient experiences and the clinic's goals.

Transparency---- open and honest with our patients about care plans, care expectations, financial responsibility and long term follow up care. Staff knows what is expected of them and what is required to reach the clinic's goals. They understand that if the clinic does not reach its goals then the clinic cannot help the team reach theirs. Staff is always open and honest with the team and managers about intentions and goals.

Result----- we strive to get our patients the best results possible. We know having the clinic run at a high level that is healthy in progressing in all areas of service, efficiency, consistency, and finances is what allows us to obtain those results

OTHER DUTIES

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice

Commitment to Diversity:

As an equal opportunity employer committed to meeting the needs of a multigenerational and multicultural workforce, Core Medical Center recognizes that a diverse staff, reflective of our community, is an integral and welcome part of a successful and ethical business, we hire local talent at all levels regardless of race, color, religion, age, national origin, gender, gender identity, sexual orientation, or disability, and actively foster inclusion in all forms both within our company and across interactions with clients, candidates and partners.

Job Type: Full-time

Pay: $17.00 - $20.00 per hour

Benefits:

• 401(k) matching

Schedule:

• Monday to Friday

Work setting:

• In-person
• Office
• Outpatient

Ability to commute/relocate:

• Blue Springs, MO 64015: Reliably commute or planning to relocate before starting work (Required)

Experience:

• Workers' Compensation: 1 year (Preferred)

Work Location: One location