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PACS Services

Post-acute care facility operator and investor

Workers Compensation Specialist

Claims AdjudicationPosted on Nov 5
Full-timeUnited StatesNo salary listed

About the Job

Requirements

  • A bachelor's degree (B.A.) from a four-year college or university is required.
  • Travel by auto or airline is required 25% of the time, with travel to facility sites potentially reaching 80% of the time.
  • The role requires the ability to track assigned claims through successful and timely completion.
  • The role requires the ability to organize and prioritize a heavy workload to meet deadlines.
  • The role requires trustworthiness and discretion when handling highly confidential information.
  • The role requires the ability to spend prolonged periods standing, speaking, walking, driving, and/or sitting.
  • The role requires the ability to occasionally lift up to 25 pounds.
  • The role may require prolonged sitting, walking, or standing; operating a computer and keyboard; near visual acuity to review written documentation; and the ability to hear and understand speech at normal room levels and on the telephone.

Responsibilities

  • Facilitate and direct workers’ compensation processes in accordance with established Legal Risk Department and industry-recommended practices.
  • Ensure each affiliated facility can access recommended employee safety and workers’ compensation programs and understands how to apply them, including internal claims investigations, accurate and timely claims reporting, first aid and triage, transportation to medical provider networks, and return-to-work programs.
  • Initiate contact with injured employees and explain the workers’ compensation process.
  • Explain the roles of the insurance company, employee’s physician, employer, and wellness manager during recovery.
  • Incorporate claim information into claim files, document conversations accurately and completely, and maintain electronic files of communications related to injured employees’ claims.
  • Ensure claim information and injury reports are accurately and promptly referred to the appropriate insurance carrier.
  • Serve as a professional liaison between operations and claims adjusters.
  • Ensure facilities maintain contact with treating physicians after employee visits to obtain work restrictions and information about the employee’s condition and treatment plan.
  • Measure and report clinics’ compliance with recommended protocols.
  • Stay in contact with injured employees and gather updates on their health conditions; consult with physicians, nurse case managers, claims adjusters, and project staff to determine whether employees are following prescribed treatment plans.
  • Liaise among injured employees, physicians, insurance companies, nurse case managers, and management to obtain timely return-to-work releases.
  • Maintain communication with insurance carriers and prepare status reports on critical claims for management.
  • Work with brokers and insurers to produce monthly claims reports for operations.
  • Direct monthly internal calls with facility management and quarterly claims reviews with insurers.
  • Consult with Human Resources and other company staff.
  • Develop and assist with implementing risk-avoidance programs as needed.
  • Accept other assignments as needed.
  • Coach and mentor other positions within the company.

About the Company

PACS Services

Post-acute care facility operator and investor

PACS Group is a holding company that runs a national platform of post-acute care facilities. It acquires, owns, and manages skilled nursing facilities, assisted living centers, and other long-term care sites, then provides healthcare services to patients after hospital stays. Revenue comes from services provided at these facilities and is paid by Medicare, Medicaid, private insurance, and patient payments. The company’s performance depends on occupancy, reimbursement rates, and how efficiently the facilities are run. Compared with competitors, PACS stands out as a large, publicly traded operator with a broad national footprint focused on growing its post-acute care platform through acquisitions and operational improvements. Its goal is to expand access to post-acute care and create value by owning and optimizing a network of care facilities that serve elderly and chronically ill patients.

Company size
11-50
Company stage
IPO
Headquarters
San Francisco, CA
Founded
2015

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