Rapid Response Claims Examiner
ProMedica - Columbus, OH

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Job Description:
This position is located at our HMS Columbus office.
The Rapid Response Claims Examiner is responsible for
the initial processing of workers’ compensation claims
to ensure accurate and complete information, and must
case-manage minor injuries to promote a successful
return to work. To perform this job successfully, an
individual must be able to perform each essential duty
satisfactorily. The requirements listed below are
representative of the knowledge, skill and/or ability
required. Reasonable accommodations may be made to
enable individuals with disabilities to perform the
essential functions.
  • Adhere to all Health Management Solutions (HMS)
policies and URAC standards.
  • Adhere to all confidentiality policies and
guidelines
  • Ensure that all documentation is current, accurate
and complete
  • Remain current with all diaries
  • Staff all difficult cases with the Nurse Case
Manager
  • Follow all HMS and BWC guidelines for appropriate
medical management of claims

Job Requirements:
EDUCATION
  • High School/GED Certificate
EXPERIENCE
  • MCO/TPA experience preferred
  • Knowledge of medical terminology preferred
REASONING ABILITY
  • Abilities to set priorities and organize
  • Ability to manage multiple projects

About this company
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Established in 1986, ProMedica is a locally owned, nonprofit healthcare organization serving northwest Ohio and southeast Michigan. Driven...