Rtw Coordinator
York Claims Service Inc (Orange County, California)

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Southern California Risk Management Associates (SCRMA) part of the York Insurance Services Group, provides nation wide claims administration services for both insured and self-insured, public and private employers.

SCRMA is committed to meet and exceed our client's expectations with customized claims administration services by recognizing and adapting to the ever changing industry environment, while attracting and retaining the highest quality personnel and clients.

SUMMARY:

This position is a third level position responsible for coordinating the execution and continued quality of the Return To Work Program/Process while working in the Riverside Office or applicable office of client location. This support extends to the designated employer contact, medical provider, designated site contact and injured worker(s). Job duties center on coordination of all temporary return to work (modified duty/alternate work). The return to work coordinator acts as a liaison between the medical provider, employer and injured worker in facilitating and monitoring early return to work. This role is also responsible for identification/development of appropriate mod/alt duties for early return to work and will ensure provider and employee participation through ongoing education.

DUTIES AND RESPONSIBILITIES:

·         Work in close coordination and communication with the Employer, Injured Worker, Medical Provider and Claims Examiner, for execution of program, monitor and documentation of all return to work activity.

·         Train and Mentor the RTW Assistant(s) for completion of all claims documentation via letters and notices, etc. This includes continued audit of letters and work product of the assistant for growth and development.

·         Complete claims notepads/WorkLink Application of all return to work activity in a timely manor with a high level of accuracy and detail.

·         Communicate progress as well as challenges to the Vice President of Medical Management and/or Team Leaders for correction, assistance, and facilitation of challenges encountered both through internal process and off-site location and coordination of those efforts.

·         Develop an appropriate level of understanding of the Medical Provider Network, Utilization Review, and Medical Case Management products and internal systems (Claims Connect, Renaissance System, WorkLink Application, Word Based Programs, Excel, etc.).

·         Interface with all other internal and external departments as needed with the goal of successful interaction and coordination of all offered services.

·         Other duties as assigned.

QUALIFICATIONS:

EDUCATION:                                                  

High School Diploma

3+ years related professional experience

Prior experience in the medical management/cost containment arena of worker’s compensation claims recommended. 

SPECIAL SKILLS:

·         Strong communication skills, Effective and accurate, written and verbal form

·         Basic understanding and use of medical terminology

·         Customer service oriented – internal staff and external clients

·         Strong organizational skills which support timely and well documented action

·         Working knowledge of Microsoft Office, excel and windows based products

·         Must be able to give direction and mentoring to support staff

SCRMA offers a competitive wage and a comprehensive benefit package that includes medical, dental, vision, short and long term disability, and pension plans. 

If you are interested in working for SCRMA, you may submit your resume by e-mail to Devora.brainard@york-claims.com

Please include salary requirements.