Importante grupo
Bililngual Medical Case Manager (Colombia)
Job Description
Position: Bilingual Medical Case Manager
Shift: Monday – Friday, 8:00 AM – 5:00 PM MST
Rate: $700-$850/monthly
Role Overview
Responsible for clinical review, treatment authorization, lien management, and case progression in personal injury matters, ensuring medical necessity, financial protection, and timely case resolution.
Key Responsibilities
- Clinical & Causality Review
- Review medical records to assess injury severity and treatment appropriateness
- Validate medical necessity for advanced treatments (MRI, injections, surgery)
- Ensure treatments are accident‑related and distinguish pre‑existing conditions
- Financial & Lien Management
- Approve or deny treatment funding based on policy limits and settlement value
- Manage Letters of Protection (LOPs) and lien documentation
- Review provider billing for accuracy and prevent upcoding
- ...