Review Vacancy
TitleMedical Care Representative
Occupational CategoryHealth Care, Human/Social Services
Bargaining UnitPS&T - Professional, Scientific, and Technical (PEF)
Salary RangeFrom $55126 to $70013 Annually
Minimum Qualifications Reachable on current open competitive Civil Service list for this title, or one year of permanent competitive class service as a Medical Care Representative.
Duties Description The primary responsibilities of the Medical Care Representative (MCR) are conducted in an office setting. Medical Care Representatives act as a medical resource for assigned claims teams with evaluation of medical information and recommendations for treatment or services to provide cost effective resolution. MCR's are the resource for approx. 10-12 case managers. They are resources for NYSIF bill payers and hearing representatives. MCR's work with outside vendors to assure appropriate and cost effective services provided to claimants. They evaluate and monitor claimant's care provided in acute, sub-acute and rehabilitation facilities; monitor home and vehicle modifications for catastrophic claims within their assigned claims team to control costs; audit and reimburse inpatient, ambulatory surgery, surgical and other complex medical bills for their assigned claims teams to assure appropriate reimbursement. MCR's communicate with the Worker's Compensation Board Rehab Bureau and coordinate all defenses with qualified vocational experts.
Additional Comments This position is eligible for an additional geographical pay differential of $5,579.
Some positions may require additional credentials or a background check to verify your identity.