Case Manager (Hybrid) #ESF8081

Duties will include:

• Places an introductory call to the client within the first 24 hours of receiving the case assignment. If the client is unavailable a message will be left on their voicemail and an email or text will follow.
  
• Assessing the completeness of the case documentation and obtains missing documentation, if required.
  
• Reviews documentation and accuracy of information with client.
  
• Sets client up with necessary medical treatment and/or ensures the client is treating through their own providers. –
  

Maintains client file with progress reports and claim status (while complying with established organizational guidelines).

• Answers all phone calls promptly, professionally, and using a friendly greeting.
  
• Serves as a liaison by communicating with adjusters and medical providers and lien holders.
  
• Helps in the process of finalizing the property damage and obtaining any rental or loss of use for the client.
  

-Scans documents related to the case into the client case system file, and sends any requests or liens via fax or email.

• In the event the client has med pay coverage and it is not in excess, submits reports and bills in order to obtain the limit amount.
  
• Communicates with the client on a regular basis about the case (at least twice a month), including updating the client on the claim process and associated timeframes and adds detailed notes.
  
• Updates case management system at every stage of the case, documenting all pertinent information and conversations.
  
• Timely files any governmental claims via certified and return receipt mail and requests a conformed copy of each claim filed.
  
• Calendars the “45 day from date the claim was mailed out” in the case management system.
  
• Assesses if additional treatment is needed and/or approved on each case.
  

-Reviews the police reports and medical records obtained by the Records Clerk. On Serious Injury Cases (SI), forwards these reports to the Team Attorney.

• For Serious Injury (SI)Cases: Follows up with Records Clerk in order to obtain the police report, establishes liability, requests the policy limits of the defendant, obtains the client declarations page, obtains any important evidence (i.e. PD photos, injury photos, videos, witness statements, etc.) –
  

For Pre-Procedure Evaluations: Drafts the PPE questionnaire, obtains the reports, bills and

estimated cost or each procedure, obtains the defendant’s policy limits, runs and ISO on the

client, and provides all information to the Lead Attorney for their review. For surgery evaluations runs a Criminal Background Check (CBC).

-Contacts client to over the ISO and/or CBC with client to confirm the information and/or obtain any pre-ret treatment regarding any previous accidents. Adds a note regarding the ISO/CBC review.

-CM will obtain medical provider full contact information, prior attorney information and provide this to their respective RC for cases where there are pre-existing accidents as they will request the records.

• Consults and advises clients regarding loss wages claims and credit issues.
  
• Resolves problems. Consults with Pre-Lit Manager regarding claims process and special, unusual, or complex circumstances.
  
• As required and under the direction of an attorney, assists in the negotiation process for a
  

client’s case (case by case)

• Seeks opportunities for clients to submit favorable online reviews about their experience with the firm.
  
• Maintains utmost professional standards towards the Firm and its clients.
  
• Achieves high customer satisfaction in the claims process.
  
• Other tasks as assigned.
  

Requirements:

• Strong customer service skills, including sense of compassion and empathy.
  
• Effective problem-solving abilities.
  
• Strong attention to details.
  
• Excellent written and verbal communication skills and organizational abilities.
  
• Solid knowledge of case management and systems.
  
• Ability to develop trust in constituents and staff.
  
• High level of understanding about insurance benefits and priority processes.
  

-General computer skills with working knowledge of Microsoft Word, Excel, Outlook, and Litify case management software.

• Professional demeanor and appearance.
  
• Strong personal focus on meeting or exceeding individual, department, and Firm goals.
  
• Ability to work effectively within a team-oriented work environment.
  
• Ability to work independently and efficiently; able to prioritize tasks.