Claims Adjusting: Responsible for approving or denying assigned claims and coordinating all aspects of claims management. Acts as the primary resource to the Workers' Compensation Agent.
Utilization Review: Responsible for reviewing medical treatment for appropriateness and necessity.
Rehabilitation: Consists of Medical and Vocational types. Responsible for working with the Office of Education and Vocational Rehabilitation to provide re-training for injured employees not able to perform their original work activities. Also responsible for negotiating all surgical fees as appropriate.
Independent Medical Examinations: Responsible for scheduling all independent medical examinations per MGL c 152 s 45.
Investigations: Responsible for coordinating with outside vendors on providing surveillence and other duties as requested.
Medical Bill Processing: Responsible for processing all approved medical bills associated with a claim.
Operations: Responsible for the oversight and management of daily office functions.
This information provided by the Human Resources Division