Personal Injury Assistant

Description:

The Personal Injury Assistant (PIA) is responsible for preparing large and complex paper files to be reviewed by internal and external medical consultants. This includes scanning, numbering and medically indexing medical information in the customer’s file in preparation for a medical consultant review, an Independent Medical Examination or any possible appeals or litigation. The position provides administrative support for the Personal Injury Representatives which includes requesting medical records, handling customer specific correspondence from the Medical Services Branch, Provincial Drug Plan, and the police. The incumbent contacts customers on a periodic basis to confirm that their medical condition has not changed and whether they have received any income from other sources. Claims that require further decision making or investigation are referred to the Personal Injury Representative for handling.

KEY ACCOUNTABILITIES

Note: This section is not intended to be an exhaustive list of duties and responsibilities – other duties and responsibilities may be assigned.

• Prepares large and complex paper files for the purposes of review by internal and external medical consultants. This includes scanning, numbering and medically indexing medical information to the customer file in preparation for a medical consultant review, or an Independent Medical Examination, a possible appeal, mediation, or litigation.

• Removes documents from file copies that are ‘privileged’ and not to be released and establishes a repository in case there are Freedom of Information and Protection of Privacy (FOIP) requests.

• Corresponds with customers individually or with family members, to assess the situation, field inquiries, discuss basic No Fault Injury Benefits through interpretation of the AAIA, policy wordings, and other related acts and regulations.

• Monitors payments and rehabilitation plans based on medical information obtained, and/or in consultation with treating practitioners.

• Gathers and reviews employment-related information necessary to have calculations completed for Income Replacement Benefits.

• Responds to questions and correspondence from the injured person(s), treating practitioners and/or other professional actively involved in the case regarding the status of benefits.

• Gathers medical information relating to the injured person's permanent impairment and forwards it to Rehabilitation Services for assessment.

• Obtains medical information to manage claim by disbursing all necessary forms and documents to practitioners and/or caregivers involved.

• Maintains ongoing contact with the injured person(s) and/or family, SGI Personnel, and treating practitioners as needed.

• Maintains standard file records and/or logs and may be required to search for and/or reviews file documents using manual and/or automated systems.

• Participates in group meetings with respect to rehabilitation and other benefits.

• Provides backup administrative support to the Provincial Claims Support team when necessary.