Medical Case Manager

Schedule: Monday – Friday, 
8:00 AM – 5:00 PM MST (11:00 PM - 8:00 AM PH TIME)

Medical Record Interpretation & Strategy:

• Review initial medical reports to assess injury severity (e.g., soft tissue vs. surgical)
• Read daily medical notes to understand why a doctor is recommending specific treatments (MRIs, injections, etc.)
• Determine causality: Verify that the treatment billed is actually related to the accident and not a pre-existing condition.

Financial Gatekeeping (Funding):

• Act as an internal Insurance Adjuster: Approve or deny treatment requests based on the patient's Policy Limits

Traffic Controller / Network Management:

• Coordinate referrals: Send patients to providers specifically within the client's approved network
• Radius Management: Locate providers near the patient's home to ensure they actually attend appointments
• Manage patient cycle

Caseload Managem...