Case Manager I

ABOUT THE ORGANIZATION :

The Public Employee Retirement Administration Commission (PERAC) oversees and administers the Commonwealth's public pension system. PERAC's mission is to provide regulatory oversight and guidance for the effective, equitable, and ethical operation of the Commonwealth of Massachusetts' public pension systems. PERAC oversees the 104 contributory retirement systems in Massachusetts to ensure that our public pension law, G.L. Chapter 32, is uniformly followed. Along with regulatory oversight, PERAC provides training and support to the retirement systems and members.

ABOUT THE ROLE :

PERAC is seeking a Case Manager to primarily work in the Disability Unit managing the flow of information related to : an applicants filing for ordinary or accidental disability; the review of medical panel requests, the scheduling and confirming of physician appointments, and payment process of physician appointments.

DUTIES :

1. Professionally and accurately manages the flow of information related to an applicant filing for ordinary or accidental disability; the review of medical panel requests and scheduling and confirming physician appointments under the supervision of the Manager of Medical Services as mandated by the PERAC Disability Unit procedure. Reviews Medical Panel Requests related to DALA / CRAB decisions prior to scheduling to ensure request is complete for scheduling.

2. Communicates accurate information in a professional and timely manner, to retirement boards, physicians, vendors, members and attorneys under the supervision of the Manager of Medical Services as mandated by the PERAC Disability Unit procedure. Assists retirement boards with PROSPER software related to submitting Medical Panel Requests when necessary.

3. Responsible for the maintenance of the physician / vendor file and medical panel follow-up procedures regarding documents for payment and licensure.

4. Prepares professional, accurate, forms, letters, reports and other communications, consistent with PERAC Disability Unit procedures or as advised by the Manager of Medical Services.

5. Develops and applies a working knowledge of Chapter 32 and the disability regulations.

6. Renders payment of medical bills related to medical exams associated with the Disability Unit using PROSPER software and transmits payments using the Comptrollers Interface System accurately and timely based on PERAC Disability Unit procedures or as advised by the Manager of Medical Services. Monitors payment processing for fiscal year end.

7. Prepares scanning, and file shares in the PROSPER system all medical panel documents submitted to the office as necessary. Assists with the scanning of medical documents of retired members as it relates to the review of Comprehensive Medical Evaluations conducted by the Nurse Case Managers. Reports any procedural issues to the Manager of Medical Services and IT.

8. Participates on Quality Assurance Team and participates in the review of any complaints submitted to PERAC from any party involved in the MP / CME / RTS process.

9. Oversees the retention, destruction schedule as it applies to the Disability Unit as set forth by the Secretary of State.

10. Responds to telephone calls, written requests for information, requests for files and copying of materials for office staff in a professional and timely manner, consistent with PERAC Disability Unit procedures or as advised by the Manager of Medical Services.

11. Performs a variety of word processing and data processing functions using Microsoft Office 365 Tools.

12. Assist with administrative functions within the agency including reception desk coverage during absences.

13. Assist with the annual 91A process including reviewing Annual Statement of Earned Income forms, assisting client questions, returning calls of clients, verify submissions in Prosper. Assist with scanning forms and bulk mailings of those incomplete and non-compliant lists.

14. Perform other work related duties or special projects assigned by the Manager of Medical Services.

Qualifications :

REQUIRED QUALIFICATIONS :

1. High School Graduate, College or Business Experience preferred.

2. Knowledge and Experience in medical field and / or Business-Related Field.

3. Applicants must have excellent communication, organizational skills, detail-oriented and / or medical terminology experience preferred.

4. Ability to handle confidential materials and exercise good judgment in handling such information.

5. Ability to be flexible, work independently and in a collaborative environment.

PREFERRED QUALIFICATIONS :

1. A minimum of one-year experience in medical and / or administration / business environment.

The Commonwealth is an Equal Opportunity Employer and does not discriminate on the basis of race, religion, color, sex, gender identity or expression, sexual orientation, age, disability, national origin, veteran status, or any other basis covered by appropriate law. Research suggests that qualified women, Black, Indigenous and Persons of Color (BIPOC) may self-select out of opportunities if they don't meet 100% of the job requirements. We encourage individuals who believe they have the skills necessary to thrive to apply for this role.