Texas Healthcare Foundation Work Values

Daily Duties at Texas Healthcare Foundation:

Provide exceptional customer service to any and all callers. Handling of medical only and lost time work injury claims with deductibles ranging from $2,500.00 to $100,000.00. Immediately input injury claims and initiate a 24 hour 3 point contact with employee, employer and medical provider. Set reserves for all claims up to $10,000.00 without supervisor approval. Use of a diary date system to maintain a proactive position on open claims. Set up appointments for injured employees for initial or follow up appointments, IME’s, second opinions, specialists or diagnostics as needed. Adjudicated Shock Loss Claims with little supervision. Locate and negotiate with non-contracted medical providers for services as needed. Filing of all medical notes, medical bills and any documentation pertaining to the claim. Calculate wage replacement for lost time injuries and issue checks as requested by the employer. Review medical bills for accuracy also review EOB’s following bill processing and issue checks as requested by the employer Assign nurse case management as needed. Worked closely with nurse case managers to make sure all medical treatment was necessary for the work injury. Interpret and implement ERISA Plans and Insurance policies on behalf of each of the employers. Drafted various letters including: denial letters, missed appointment letters, IME letters to the doctor and the employee.

What they like about Texas Healthcare Foundation:

Working for a company with an emphasis on social values and helping society is a clear and important priority for you - a critical factor in who you choose to work for. In contrast to other factors, you place an organization's reputation for fairness and concern for the community above most other aspects of the company. As you search for a new job opportunity, it is usually possible to find out if the company is involved in the community and/or if it is addressing problems and issues in society. Pay special attention to non-profit organizations and those specifically involved in social action. Moreover, speaking with current and former employees should enlighten you to perceptions of the fairness of the company's leaders and the treatment of employees.

Tags

Adjuster, Non-Subscriber, Insurance, Licensed, Lost Time Claims, Medical Only Claims

Skills

Customer Service, Commnicating Well With People, Working Independently , Working Well As A Team, Adjudicating Injury Claims, Organization Skills, Learning New Skills

These are some of the questions we asked our climbers about their experiences with Texas Healthcare Foundation: