Tristar Insurance

The medical case manager provides telephonic case management within a workers' compensation setting, coordinating resources and cost-effective options to achieve individualized treatment goals and facilitate return to work. Key duties involve conducting initial assessments, maintaining contact with all involved parties, formulating clinical case plans, and monitoring medical appointments to promote positive treatment outcomes.

The examiner manages all aspects of indemnity claims from start to finish within established authority, handling a caseload of 150 or fewer workers’ compensation files, including complex cases. Duties involve initiating investigations, determining compensability, administering benefits, managing medical treatment, and settling claims.

The examiner manages all aspects of indemnity claims from start to finish within established authority, handling a caseload of 150 or fewer complex workers’ compensation files. Duties include initiating investigations, determining compensability, administering benefits, managing medical treatment, setting reserves, and settling all claims.

Under general supervision, manages all aspects of indemnity claims handling from inception to conclusion within established authority and guidelines. This position requires considerable interaction with clients, claimants on the phone, and with management, other Claims Examiners,...