TPA Medical Case Manager

General Description:

Manages medical aspects of workers compensation and disability claims for Third Party Administration (TPA) accounts by coordinating with patients, physicians, other health care providers and employers to facilitate positive patient outcomes, timely return to work if applicable and efficient claims resolution.

Responsibilities:

• Manages activities of workers compensation and disability claims, case management and utilization review according to established policies and procedures and applicable legal and regulatory guidelines.
• Manages ongoing managed care activities, including case management of medical aspects of workers compensation and disability claims for TPA accounts by coordinating with patients, physicians, other health care providers and employers to facilitate positive patient outcomes, timely return to work if applicable and efficient claims resolution and utilization review, gat...