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WC Clinical Support Coordinator- Qual-Lynx (NJ) at Cigna

Posted in General Business 30+ days ago.

Type: Full-Time
Location: Piscataway, New Jersey





Job Description:

Job Summary- Case Management Senior Representative (Workers' Comp Clinical Support Coordinator)

Workers’ Comp (WC) Clinical Support Coordinator will work with clinical teams to efficiently and accurately transcribe and enter medical documentation into the Workers Compensation system under the direction of the Nurse Case Manager (NCM). Works as a backup to the Intake Team and other clerical staff doing Faxpress, intake and clerical duties for the department.

Location: This role will start remote, then move to onsite in the Piscataway, NJ or Egg Harbor Twp, NJ office

Duties


  • Scheduling appointments with network providers and sending precertification letters under the direction of the NCM.

  • Understand and assist with the Intake process and the completion of the NJ State Workers’ Compensation First Report of Injury (FROI).

  • Coordinate the notification of the FROI electronically and updated notes and information to clients, adjusters and nurses.

  • Telephonic intake of Workers’ Compensation injury information and completion of the interview questionnaire.

  • Direct initial treatment when necessary under the supervision of the NCM.

  • Assist nursing teams with clerical duties and coordinating information to be entered into the WC system.

  • Transcribing medical documents in the WC system under the direction of the NCM.

  • Assist with all clerical duties for the nursing teams and the department as needed.

  • Purging and organizing charts for archiving, scanning and emailing FROI and other documents to clients and adjusters.

  • Maintain case files for the nursing teams.

  • Effective, consistent and accurate communication with injured workers, employer clients, claims adjusters and NCM.


  • Ability to manage high volume of telephone calls and a fast paced work environment.

  • Provide standard of excellence when communicating to internal and external contacts.

  • Develop and maintain favorable relationships with clients, providers, injured workers, claims adjuster and coworkers.

  • Maintain compliance with Federal, State and Local Workers’ Compensation regulations.

  • Effective time management and organizational skills and adherence to HIPAA guidelines of confidentiality.

  • Ability to work independently and collaboratively with the NCM(s) to identify and anticipate case management needs of the injured worker.

  • Assertive and positive work style and the ability to think critically.

  • Time management and organization of work functions.

  • Excellent communication and people skills necessary to effectively work with network provider staff, interview injured employees and to work with the nursing teams.

Requirements

High School Diploma required, Medical Assistant Certification preferred.

At least one year experience in a healthcare environment/provider office

Excellent Customer Service skills

Strong MS Office (Word and Excel)

Medical Terminology      

Worker’s Compensation knowledge a highly desired

About Cigna

Cigna Corporation (NYSE: CI) is a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. We offer an integrated suite of health services through Cigna, Express Scripts, and our affiliates including medical, dental, behavioral health, pharmacy, vision, supplemental benefits, and other related products. Together, with our 74,000 employees worldwide, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation.

When you work with Cigna, you’ll enjoy meaningful career experiences that enrich people’s lives while working together to make the world a healthier place. What difference will you make?  To see our culture in action, search #TeamCigna on Instagram.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.





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