Founded in 1991, Injury Management Organization, Inc. (IMO) is a managed care company serving public and private employers, nonsubscribers, insurance carriers and third party administrators. Taking quality and client satisfaction seriously, our focus is driven by provider relationships, employee engagement and measurable outcomes.
We are a trusted managed care partner for both private and public enterprise with vast experience in quality case management and positive injured employee outcomes. For over three decades our goal has been to provide industry leading customer service to our industry partners and their injured employees - a goal that has allowed IMO to grow from Texas into multiple other states including Arkansas, Florida, Illinois, Colorado, Louisiana, Oklahoma, Arizona, and New Mexico.
This is a full-time position in Plano, TX - Hybrid role after completion of 90-day training, full benefits, PTO, paid holidays, matching 401(k), $50,000 life insurance paid by IMO.
SUMMARY Process incoming requests for Peer Review /Required Medical Exams /Designated Doctors Exams /Retrospective Utilization Reviews and Liability Medical Analysis from clients and from health care provider bill submissions. Collect clinical data to support the request in order to forward the file for PR/RME/DDE/RUR/LMA. Compile, process and maintain medical records of injured employees in a manner consistent with medical, administrative, ethical, legal and regulatory requirements of the health care system. Relies on instruction and pre-established guidelines to perform the functions of the job. Familiar with standard concepts, practices and procedures within the medical field, Division of Workers Compensation and the Texas Law regarding workers compensation.
Coordinate and process in excess of 20 ancillary services requests weekly Scrub and organize in excess of 20 files weekly of medical records ranging from 1-1,000 pages Answer phones and reply to emails within 1 business day, in excess of 20/daily The successful candidate will possess an a dvanced skill level in computer literacy to enter, access or retrieve data with high level of accuracy and type 40+WPM, and be f amiliar with medical terminology, ICD-10 and CPT coding. Possess the a bility to conduct face-to-face discussions with individuals and team. Must adhere to and meet TDI and state regulated guidelines and mandated timeframes. Have e xcellent communication skills, both oral and written, with internal and external customers and the public. Ability to work well with electronic mail, fax and phones. Be s killed in conflict resolution and m ust be organized and capable of multi-tasking. Know and be f amiliar with standard concepts, practices and procedures within the medical field. Familiar with Division of Workers Compensation and the Texas Law regarding workers compensation. Facilitate initial receipt and expediting state regulated guidelines and mandated timeframes.
EDUCATION and/or EXPERIENCE
High school graduate or equivalent Prefer some college Medical office experience of 2-3 years Coursework in medical terminology a plus Knowledge in Texas Workers Compensation Rules and Guidelines Ability to understand and interpret medical records Bilingual in Spanish a plus
