Job Summary
Job Description
MAJOR DUTIES AND RESPONSIBILITIES:
Analyzes injury/medical reports. Once information is verified, the Care Coordinator formulates a plan of action for that injury. Will collaborate with treating providers as needed and requested on case management issues.
Contacts appropriate employer/adjuster/case manager to verify information, promote and educate regarding limited duty concepts.
-
Must thoroughly understand and promote to all concerned, Outcome Assurances concepts and philosophies regarding prospective case management.
Tracks and manages for PT recapture opportunities when a patient is referred to an external AMS provider for care, i.e. surgical patients. Communicates/Negotiates with referral provider when PT is not referred back to Concentra. Collaborates with leadership team when this occurs.
Other duties as assigned.
Referral Coordination Responsibilities:
Reviews/Processes all diagnostic/specialty/miscellaneous referral requests by the AMS providers.
-
Obtains authorization for referrals and schedules appt. as appropriate.
Assures referrals are maintained within appropriate networks.
Communicates with all stakeholders, payers, employers, case managers, patients as appropriate and as per protocol.
Records all appropriate information via OA/CR module of OccuSource per Policy & Procedure.
Builds relationships with provider and payer community.
Concentra's Data Protection Commitment
* Concentra is committed to protect patient data and to ensure privacy of personal and medical information.
* Every Concentra colleague has the responsibility to adhere to data protection principles.
* If a colleague's role includes handling or processing sensitive data, role-specific policies and requirements apply to ensure the protection of patient information.