Job purpose

An exceptionally detail oriented Customer Service professional that performs a variety of tasks for MiCARE. The Case Manager is the primary point of contact for attorneys and law firms, as well as many high-level healthcare professionals. 

Duties and responsibilities

The Case Manager will be responsible for working closely with the Schedulers and Surgery Coordinators, under the parameters of the Underwriting Director and Director of Finance, in order to underwrite the facts and economics of each case/claim, approve recommended appointments, coordinate and approve the requested orders sent to MiCARE from chiropractors and other treating physicians, review reports and files to forward to medical providers and attorneys.

Must be able to gather, analyze and examine information and documents and manage a high-volume case load. Must be able to multi-task, prioritize and demonstrate acute attention to detail. Excellent Customer Service and organizational, written, telephone and communication skills are essential. Must be a team player and able to function in a fast-paced, high volume work environment.

Primary functions:

• Excellent Customer Service and Concierge services to the law firms, attorneys, medical providers and patients.
  • Excellent underwriting skills:
• Identify the clinical profile of the patient/client and update it continuously with each medical report as treatment plan recommendations are given by treating providers.
• Primary responsibilities will include approving recommended orders/appointments with law firms based on preestablished tiers of approval based on order values:  Forward approvals to the Schedulers so that they can contact patients, medical providers and documenting the details of each appointment.
• Execute the initial intake call with patient/client and fill out the intake form for each case.
• Maintain and update Case Management master spreadsheet database, ensuring that appointments and notes are accurately and completely entered into the MICARE system.
• Develop and email a Clinical Profile on a bi-weely basis to the assigm attorney of each case.
• Ensuring that cases are underwritten and reviewed by as per the Director of Underwriting parameters prior to approving appointments.
• Must have the ability to exercise a high degree of diplomacy and tact; excellent customer services and interpersonal communication skills; Cultural intelligence, patient sensitivity and demonstrated ability to work with diverse racial/ethnic and cultural groups.
• Develop and nurture strong customer relationships with the referring attorneys and law firms, as well as the medical providers.
• Resolve customer service issues in a knowledgeable and friendly way – think outside the box!
• Ensure customer satisfaction is delivered, even under the most difficult circumstances.
• Perform other related duties as assigned by the Director of Operations.

Skills

• Understands the importance of maintaining confidentiality; able to maintain confidentiality under HIPAA standards.
• Strong attention to detail with the ability to work quickly and accurately in a fast-paced environment.
• Excellent customer service skills – knows how to service an account, how to build relationships with customers, providers and patients.
• Strong written skills with proper grammar, spelling and punctuation to document Notes in Case Profiles, communicate with professionals (attorneys, physicians and providers, etc.) via eMails, faxes, and outgoing and printed documents
• Able to handle up to 15+ phone calls/hour while multi-tasking on computer.
• Candidate is a good team player, gets along with others, etc.
• Works at high volume capacity with both speed and accuracy.
• Candidate can problem solve independently.
• Eager to learn, flexible about how the position may evolve, looking for opportunity to grow in skills and experience.
• High competence and experience with Microsoft Word and Excel, Outlook

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The qualifications listed below are representative of the knowledge, skill and/or ability required.

Qualifications include:

• Must be fluent:  bilingual in both in English and Spanish
• Candidate should have at least a high school Diploma, preferably a Bachelors Degree or 5+ years of experience in the Legal and/or Medical field
• 5 to 10 years Customer Service Experience
• Medical background helpful
• Experience or knowledge of the legal claim management for Personal Injury victims helpful

Working conditions

The Case Manager position operates in a professional office setting.  Weekly schedule is:  Monday through Friday from 8:30 am to 5:00 pm.

Physical requirements

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is frequently required to sit and use hands, fingers, handle, feel and reach with hands and arms. The employee is occasionally required to stand, walk, stoop, kneel, crouch, talk or hear. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision.

Direct reports

This job has no supervisor responsibilities.