Case Manager – Medical & Legal Coordination

About the role

We are seeking a skilled Case Manager to bridge the gap between patients, medical providers, and attorneys in a US personal injury environment. You will interpret medical records, verify treatment relevance, and manage the financial flow of claims.

Key responsibilities

• Review initial medical reports to assess injury severity and determine appropriate treatment pathways.
• Read daily clinical notes to understand physician recommendations and ensure they align with the accident.
• Verify causality and confirm that billed services are directly related to the injury, not pre‑existing conditions.
• Act as an internal insurance adjuster, approving or denying treatment requests based on policy limits.
• Coordinate referrals within the approved provider network and manage provider proximity to patients.
• Maintain a caseload of 25‑30 active cases, serving as the primary liaison among patients, providers, and attorneys.

Required profile

• Medical graduate (BS Nursing preferred or equivalent healthcare degree).
• Experience in case management for US personal injury law firms or medical funding/lien companies.
• Familiarity with the lifecycle of a personal injury lawsuit (intake, treatment, settlement).

Required skills

• Proficiency with legal CRM platforms such as Filevine, Salesforce, or Smart Advocate.