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Case Management Associate - Albany New York
Company: Sedgwick Location: Albany, New York
Posted On: 04/28/2024
Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive. A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you're someone who cares, there's a place for you here. Join us and contribute to Sedgwick being a great place to work. Great Place to Work - Most Loved Workplace - Forbes Best-in-State Employer Case Management Associate PRIMARY PURPOSE : To access and assign workers compensation, disability and liability cases applying current policies and procedures per state workers compensation laws; and to increase efficiency of operation by providing general customer support duties and supporting the medical staff in a team environment. ESSENTIAL FUNCTIONS and RESPONSIBILITIES -
Accesses and assigns cases for medical case management, utilization review and clinical consultation. -
Provides accurate information to callers based on customer requests; triages telephone calls between utilization review, clinical consultation and telephonic case managers. -
Enters new claims data into the claims management system accurately; maintains data integrity. -
Supports clinical staff through the completion of components of the case management and utilization review process. -
Schedules diagnostic tests and physician appointments as assigned. -
Provides channeling services for injured workers, employers and claims examiners by directing into PPO network for treatment. -
Gathers statistics for record keeping and provides reports as required. -
Ensures by confirmation that fax forms and filings required by regulatory agencies have been received; distributes, faxes, mails and copies incoming and outgoing correspondence. ADDITIONAL FUNCTIONS and RESPONSIBILITIES -
Performs other duties as assigned. -
Supports other units as required. -
Supports the organization's quality program(s). QUALIFICATIONS Education & Licensing Associate's degree or two (2) years of college preferred. Experience One (1) year of administrative experience required. Customer service experience in a medical field preferred. Worker's compensation, disability and/or liability claims processing experience preferred. Skills & Knowledge |
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