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| POSITION DESCRIPTION | GENERAL INSURANCE INDUSTRY NOVEMBER 2008 |
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Case Coordinator |
| Position Code: | 4371 | | Career Level: | 4 |
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Responsible for
Pro-actively developing case management strategies tailored to the needs of individual injured workers that are designed to facilitate; early return to work; appropriate and timely treatment; and effective management of costs. |
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Reports To
Team Manager. |
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Supervises
May supervise Case Officers. |
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Main Activities
Providing support to the Team Manager and Team Leader by acting as a role model, coaching Case Managers and providing assistance with Team management activities as required. Acting in a supervisory capacity in the absence of the Team Leader (Claims Processing).
Leading, mentoring and coaching Team Members to ensure effective injury management of high-risk claims and correct processing of low-risk claims.
Checking Case Managers reports, quality checking reviews and providing feedback and coaching where areas for improvement have been identified.
Providing a high level of customer service by focusing on delivering solutions that meet customer needs and expectations. Working effectively with customers, Team Members and third parties to find solutions consistent with customer needs and expectations, Organisation’s business objectives and that promote the desired WorkCover culture.
Managing high risk claims, with Multi-Disciplinary Team (MDT) support where appropriate including; determining pro-active case management strategies; and implementing Case Management Action Plans (CMAP’s).
Conducting regular file / claim reviews to ensure strategy and case estimates remain appropriate and desired outcomes are being achieved.
Ongoing assessment, identification and management of special claims (common law, impairment benefit, fraud, recovery).
Monitoring providers and ensuring cost and quality of service meets or exceeds expectations. Identifying, in consultation with the MDT, client performance issues (including failure to comply with legislative requirements) impacting on injury management and implement actions to improve performance.
Monitoring and improving Organisational practice and procedure for compliance in line with VWA requirements and aid in the achievement of more efficient / effective outcomes. Adhering to Internal Control guidelines.
Continuing development of legislative, technical and injury management knowledge through on the job training and attending internal / external courses as required.
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Key Skills
Effective people management, communication and conflict resolution skills.
Working knowledge of Workers Compensation legislation.
Knowledge of common and complex work related injuries and their effective management.
WorkCover computer systems (including Action) skills.
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Internal Contacts
Workers Compensation Department, Claims Specialists, OH&S Specialists. |
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External Contacts
Employers, Health Professionals. |
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Typical Experience
At least 4 - 5 years Workers Compensation experience in the application and interpretation of Workers Compensation Legislation, coupled with relevant qualifications. |
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