
201 - 500 employees
Founded 1999
⚕️ Healthcare Insurance
☁️ SaaS
📋 Compliance
Healthcare Insurance • SaaS • Compliance
Rising Medical Solutions is a company that provides comprehensive solutions for managing the costs and quality of medical care. Their services include medical bill review, care optimization, provider negotiations, and analytics and technology solutions aimed at reducing medical costs and improving care outcomes. The company also offers Medicare compliance solutions, utilization review, peer review, and a variety of management services tailored to enhance the efficiency and effectiveness of medical claims management. Rising Medical Solutions focuses on delivering optimal care at the right price, using advanced analytics and risk modeling to inform decisions and improve service delivery for clients.
🕒 May 8
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201 - 500 employees
Founded 1999
⚕️ Healthcare Insurance
☁️ SaaS
📋 Compliance
Healthcare Insurance • SaaS • Compliance
Rising Medical Solutions is a company that provides comprehensive solutions for managing the costs and quality of medical care. Their services include medical bill review, care optimization, provider negotiations, and analytics and technology solutions aimed at reducing medical costs and improving care outcomes. The company also offers Medicare compliance solutions, utilization review, peer review, and a variety of management services tailored to enhance the efficiency and effectiveness of medical claims management. Rising Medical Solutions focuses on delivering optimal care at the right price, using advanced analytics and risk modeling to inform decisions and improve service delivery for clients.
• Manage and/or assign files to appropriate staff member 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. • Maintain responsibility of an individual caseload. • Maintain appropriate electronic and paper files. • Interface with a variety of inter-disciplinary providers (e.g., PT, diagnostic, psychology, etc.). • Identify, maintain, and update participating providers. • 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. • Work as part of a team to meet turn-around time for the set activity. • Keep supervisor advised of any problems or delays. • 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.
• Experience in any of the following disciplines a plus – CNA, Medical Assistant, Physical Therapy Aide, Workers’ Compensation, Medical Unit Claims Administrator, IME Coordinator, Medical Office Manager • Experience with workers' compensation or disability (a plus!) • Bachelor's or Associate's Degree preferred but not required • Intermediate computer and internet skills (will work with programs including MS Word, Outlook, and Excel) • Basic knowledge of/ability to read medical reports • The ability to research evidence-based guidelines • An understanding of workflow guidelines and follow as necessary • Proficient verbal/telephone and written communication skills • A high level of efficiency, ability to maintain rapid workflow • An aptitude for learning, organization skills and the ability to follow systems and procedures • A time-management mindset, along with planning, and prioritization skills • The ability to work independently as well as part of a team • The ability to express empathy with injured and/or disabled people • A customer service mindset • Ability to work Monday-Friday on a 1st shift central time zone
• Comprehensive benefit package including health/dental/vision insurance, profit sharing, 401k matching, generous time off • Traditional first shift schedule • A relaxed, yet upbeat, work environment, with a jeans professional dress code when onsite • In-office days reserved for training or team events • Awesome downtown location in River North • Close to public transit • Rising was named a Top Workplace in the healthcare industry for 2023! Check out our profile here: Rising Medical Solutions, Inc Profile (topworkplaces.com)
Apply Now🕒 May 7
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