JOB SUMMARY: Manages uncomplicated medical only claims including but not limited to needlesticks and blood/body/fluid exposures, with determination of compensability and compliance with state regulations with minimal guidance.
Opens uncomplicated medical only claims, primarily needlesticks and BBF claims in accordance with office protocols, including establishing initial reserves.
Manages expenses associated with assigned claims.
Ensures that all state guidelines are met for assigned claims, including state reporting and appropriate follow up documentation (needlestick letters) from the state.
Coordinates medical care and communication with employee regarding assigned claims.
The responsibilities listed are a general overview of the position and additional duties as assigned.
May assist with property, auto, and general liability claims.
Assists with CMS and OSHA reporting.
COMPUTER LITERACY (INTERMEDIATE): - Knowledge of the use of applications and other tasks on computers as part of regular work responsibilities. It includes knowledge of personal computers utilizing software such as word processors, spreadsheets, text editors, and graphics.
CUSTOMER SERVICE (NOVICE): - A continuing focus on the needs and requirements of customers, anticipating their needs, remaining sensitive to customers while performing services for them, responsive to customer needs.
SYSTEM KNOWLEDGE (INTERMEDIATE): - Knowledge of the operation and support of the system from the standpoint of computer operations, network operations, and/or technical support.
WORKERS COMPENSATION (INTERMEDIATE): - Knowledge about the Company's Workers Compensation insurance and benefits provided to employees who are injured or contract an occupational disease due to their employment.
Organizational Impact: Performs tasks that are typically routine that may impact team's performance with occasional guidance.
Problem Solving/ Complexity of work: Utilizes some discretion and research to solve routine problems.
Breadth of Knowledge: Applies knowledge of standards, established processes and procedure that apply to your own job.
Team Interaction: Provides guidance to entry level co-workers.
Vanderbilt University Medical Center is home to Vanderbilt University Hospital, The Monroe Carell Jr. Children’s Hospital at Vanderbilt, the Vanderbilt Psychiatric Hospital and the Vanderbilt Stallworth Rehabilitation Hospital. These hospitals experienced more than 61,000 inpatient admissions during fiscal year 2015. Vanderbilt’s adult and pediatric clinics treated nearly 2 million patients during this same period. Vanderbilt University Hospital and the Monroe Carell Jr. Children’s Hospital at Vanderbilt are recognized again this year by U.S. News & World Report’s Best Hospitals as among the nation’s best with 18 nationally ranked specialties. Vanderbilt University Medical Center is world renowned because of the innovation, work ethic and collegiality of its employees. From our health care advances to our compassionate care, Vanderbilt owes its accomplishments and reputation to staff and faculty who bring skill and drive and innovation to the medical center day after day. World-leading academic departments and comprehensive centers of excellence pursue scientific discoveries and transformational educational and clinical advances across the entire spectrum of health and disease.As t...he largest employer in middle Tennessee, we welcome those who are interested in ongoing development in a caring, culturally sensitive and professional atmosphere. Most of us spend so much of our lives at work, we want to be part of maintaining a workplace in which people support one another and encourage reaching for excellence. Many high-achieving employees stay at Vanderbilt because of the professional growth they experience and because of their appreciation of Vanderbilt’s benefits, public events and discussions, athletic opportunities, beautiful setting and, above all, sense of community and purpose.Vanderbilt and its employees share a set of mutual expectations that have been created with productivity, legality, fairness and safety always in mind. We believe that our investment in training and compensating employees multiplies in value when we enable individuals to deliver their best performance for the benefit of us all.