Medical Record Interpretation & Strategy:
- Review initial medical reports to assess injury severity (e.g., soft tissue vs. surgical)
- Read daily medical notes to understand why a doctor is recommending specific treatments (MRIs, injections, etc.)
- Determine causality: Verify that the treatment billed is actually related to the accident and not a pre-existing condition.
Financial Gatekeeping (Funding):
- Act as an internal Insurance Adjuster: Approve or deny treatment requests based on the patient's Policy Limits
Traffic Controller / Network Management:
- Coordinate referrals: Send patients to providers specifically within the client's approved network
- Radius Management: Locate providers near the patient's home to ensure they actually attend appointments
- Manage patient cycle
Caseload Management:
- Manage a pipeline of 25–30 active cases simultaneously.
- Serve as the primary bridge between the Patient, the Medical Provider, and the Attorney.
Qualifications
Education:
- Must be a Philippine Licensed Lawyer.
- Must be able to read and interpret clinical notes, surgical recommendations, and diagnostic results independently.
Experience:
- Must have Case Management experience specifically supporting a US Personal Injury (PI) Law Firm or Medical Funding/Lien Company
- Experience coordinating with attorneys and understanding the lifecycle of a PI lawsuit (Intake > Treatment > Settlement)
Preferred (Bonus) Qualifications
- Experience handling cases in Colorado, Arizona, or other states where at-fault insurance pays.
- Experience with Letters of Protection (LOP) or Medical Liens.
- Experience with legal CRMs (Filevine, Salesforce, Smart Advocate, etc) is a strong plus, showing adaptability to complex software.
