1.1 1a. Receives/reviews appointment information from appointment scheduling regarding no shows , cancellations (rescheduled at time of cancellation), and reschedules. 1b. Manages authorization/precertification process in order to coordinate patient care with specialist and diagnostics including obtaining authorization for appointment, scheduling appointments, obtaining reports, and communication with patient and company. 1c. Works with medical case management coordinator Re: HSR employees'work injuries as requested/required.

2.1 2a. Establishes contact with insurances. Identifies patient needs. Logs entry into Systoc. 2b. If authorization/precertification not obtained on initial call, re-contacts adjuster in 24-48 hours. 2c. When authorization/precertification is obtained, contacts specialist's office or Physical Therapy office, secures appointment and documents in Systoc. 2d. Notifies the referral source of insurance info, claim number, medicals, MRI and x-ray reports. 2e. Follows protocol to insure that the patient is notified of the appointment, and confirms appointments with employer if unable to contact patient. 2f. Provides patient with instructions regarding appointment and office location 2g. When scheduling IE P.T. appointments, uses coding system to label appointment access which will contribute to data gathering regarding access issues for physical therapy.

3.1 3a. Follows the progress of cases requiring further clinical investigation. 3b.Uses the Systoc system to monitor status of authorization for treatment process. 3c. Follows departmental protocol, which is driven by Worker's Compensation Regulations for appropriate responses of MCO, TPA and employer, and appropriately notifies supervisor and clinicians when unable to obtain certification in a reasonable timeframe. 3d. Using Quadramed, identifies all visits to the emergency dept. for after hours care of injury sustained by employees of client companies.Documents ED visit in Systoc.

4.1 4a. Formulates and uses effective working relationships with all health care team members, patients, and significant others. 4b. Utilizes critical thinking skills and knowledge to facilitate best and timely outcomes in difficult cases. Practices effective problem identification and resolution skills 4c. Demonstrates the necessary interpersonal skills and commitment to team building and customer service. 4d.is responsible for identifying client company and patient questions or concerns; takes responsibility for identifying resource person(s) to address concerns. Assures that identified person has accepted responsibility for addressing that concern. 4e. Consistently demonstrates efficient utilization of hospital resources, and is familiar with department contingency plan and procedure. 4f. Takes initiative to prioritize activities, adjust workload, and coordinates tasks in order to be as productive as possible. 4g. Adheres to hospital and department standards of confidentiality and HIPPA compliance. , Maintains confidentiality by communicating patient and employee information in an appropriate manner only to health care care workers involved in thew care of the employee and/or patient. 4h. Upholds patient's rights as identified within the institution. Is aware and sensitive to the patient's Bill of Rights of the hospital and the ANA Code of Ethics. .

6.1 6a.Documentation: Performs complete documentation responsibilities associated with patient activities and communication 6b. Participates in gathering of statistics related to departmental activities and coordination of patient care. 6c. Responds to all requests for medical records from attorneys, subpoenas, social security disability claims, and insurers' following hospital guidelines for release of patient information. 6d. Records on excel spread sheet a record of attorney request and when mailed out or who (office/department) records were forwarded to for completion 6e. Assist in completing respirator fit testing of HSR employees as needed. 6f. Notifies department designee of updates/changes in client company demographics to be reflective in system/company profile. 6g. covers exit function as needed 6h. Accounts for and completes grant sheets on initial injuries. 6i. Assists in developing processes to assist in On Site Services program which include staffing sessions for ppd and flu clinics for HSR employees and volunteers