Rising Medical Solutions

Manager

• Establish collaborative relationships and act as an intermediary between clients, patients, employers, providers, and attorneys
• Assess, coordinate, implement, monitor, and evaluate the plan to meet the injured/disabled individual’s needs, utilizing the knowledge of medical necessity, care appropriateness, and managed care principles
• Promote quality, cost-effective care throughout the health continuum to ensure the injured/disabled individual is able to return to an optimal level of work and functioning and documenting case savings
• Document ongoing progress of all case management activity, including the organized maintenance of files containing clinical documentation of interactions with all parties of every claim
• Assess injury severity, extent of disability, treatment plans, functional abilities, and physical job requirements to establish return to work plans and strategies to manage future medical exposure

Nurse Case Manager

Administrative Assistant

• Manage and/or assign files to appropriate staff members and initiate appropriate verbal and/or written contacts with employers, clients, claimants, and medical providers.
• Set up files in all appropriate systems; assign files, when applicable, to the nurse
• Facilitate and schedule appointments as needed, and keep the Telephonic Nurse Case Manager (TCM), clients, claimants, providers, and employers informed verbally and/or in writing of any changes, delays, updates, or problems
• Maintain appropriate electronic and paper files
• Obtain authorization for medical release of information from the adjuster, as necessary, for records acquisition
• Interface with a variety of inter-disciplinary providers (e.g., PT, diagnostic, psychology, etc.)
• Identify, maintain, and update participating providers
• Utilize Share Point tool for evaluating case risk, and input all activities (including verbal and written discussions) into the Ultimate database and customer/client system
• Answer incoming calls, and direct the call appropriately
• Process all documents using computer, copier, and scanner
• Search and copy the appropriate internal criteria guidelines, when appropriate
• Screen all re-open files (subsequent URs) to determine duplicate requests, vs. an appeal request that is beyond the allotted timeframe, vs. a reconsideration, vs. a new UR
• Basic invoicing
• Continually improve job skills and knowledge of all company products and services as well as customer issues and needs, through ongoing training and self-directed research.
• Adhere to company policies, procedures, and reporting requirements.

Medical Administrative Assistant

Data Entry

• You will have the opportunity to obtain maximum savings for clients by accurately entering data and reviewing medical bills according to state laws, fee schedules, and other guidelines.
• Most of your day will include seated computer work performing data entry on workers' compensation-related medical bills.
• This position does have production and accuracy performance metrics, so if you are someone who thrives and is motivated by structured individual performance goals, this position may be a good fit.

Data Entry Associate – Entry-Level

Account Executive

• **Rising is looking for an experienced Account Executive to join our fun and customer focused Account Management team! **
• In this role you will be the primary business liaison between Rising Medical Solutions and its valued customers through developing strong, collaborative relationships with our clients. You will help set and manage customer expectations of service delivery for all Rising products and services. We are looking for someone who likes to engage with people and can foster relationships that will result in a long term partnership through anticipating and understanding customer requirements and creating solutions. The role is diverse, challenging, and consultative as you balance client needs with Rising Medical Solutions' objectives to achieve a win-win business relationship. You will be part of a team that works together, enjoys making work fun, and delivers results.

Nurse Case Manager

Medical Administrative Assistant

Data Entry Associate – Entry-Level

Account Executive – National Healthcare, Insurance