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OverviewConcentra, one of the largest health care companies in the nation, is looking for an Orthopedic Spine Surgeon to provide specialist services to our team as a 1099 independent consultant in Fresno, CA. Concentra Advanced Specialists assist in the management of medically complex patients, expedite return to work and functional restoration.
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Form a partnership with the medical case manager to maximize early return to work potential thereby reducing the need for extended disability payments, vocational rehabilitation, and other protracted claims costs.
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Utilizes the Nursing Process (assessment, diagnosis, planning, intervention and evaluation) to facilitate medical management to attain maximum medical improvement and return-to-work (RTW) per state jurisdictional requirements.
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Requires a high degree of claims handling expertise to include a minimum of at least five years experience managing indemnity cases, many with complex or high potential subrogation, rehabilitation, medical management, and/or legal issues & possess an SIP certificate.
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Requires a working knowledge of the Labor Code of the State of California as it pertains to workers compensation claims and the legal requirements for handling them. Initiate the referral to the SIU of cases with suspected fraud.
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Independently handles all assigned claims up to and including most complex where Injured worker (IW) remains out of work and unlikely to return to position. The claim involves moderate to complex litigation issuesIW has returned to work, reached Maximum Medical Improvement (MMI), and has PPD. File litigated to dispute the permanency rating and/or causality.
$65 - $108Full-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Review all medical bills for appropriateness prior to referral to InterMed for payment and posting to the claim file. Thoroughly and accurately document ongoing case facts and relevant information necessary for establishing compensability, the need for disability payments, the use of vendors, medical and expense payments, and what is being done to move the case toward closure.
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Workers Compensation Adjuster III Summary: Reports directly to the unit Claims Supervisor and may be called upon to provide technical backup in the absence of the Claims Supervisor.
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Coordinates return to work (RTW) and sets target dates. The company is increasingly winning recognition as a great place to work, earning several workplace and wellness awards, including the October 2022 Great Place to Work Award for our employee-first focus and our steadfast commitment to diversity, equity and Inclusion.
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In accordance with applicable statutes and in keeping with company rules, regulations, and established performance objectives, is responsible for effectively managing to conclusion an assigned inventory of claim files that may include cases of extreme complexity or with unique or unusual issues.
TemporaryRemoteExpandApply NowActive JobUpdated 10 days ago - UpvoteDownvoteShare Job
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Develops and manages workers compensation claims' action plans to resolution, coordinates return-to-work efforts, and approves claim payments. To analyze mid- and higher-level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements.
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With a focus on Tax & Revenue, Health & Human Services, and Justice & Public Safety, Voyatek combines the scale to support large complex projects with the agility and accessibility of a boutique solutions provider.
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Communicates with internal managed care and medical resources to ensure coordination with medical providers, injured workers and employers in developing return to work strategies and treatment plans.
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Receive, review, and process reports of on-duty employee injuries, coordinate worker's compensation claims, arrange and authorize treatment of the employee by medical care providers; review and process medical bills and solve billing/payment problems with medical providers; process return-to-work and other documents and forms required by insurance carrier, TPA, and/or State of Michigan.
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Conduct complex incident investigations, manage worker's compensation process, and return to work program. Communicate EH&S related requirements and expectations to other departments and personnel to ensure regulatory compliance and a safe work environment.
ExpandApply NowActive JobUpdated 6 days ago
compensation complex return to work jobs
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