Review medical records of employees working for FedEx on Short Term Disability/Long Term Disability/Worker’s Comp, who have a release from their treating provider to return to their DOT (Department of Transportation) position. Employee's who are in a DOT position must meet DOT regulations before returning to their job. Work closely with Liaison for FedEx’s STD/LTD (Short Term/Long Term Disability) Company (Aetna) in placing employees back to work. Work with the MRO physician's in documentation that supports DOT regulation and setting up the inner office procedures needed to work the different cases which include diabetes, cardiac, mental health, neurological disorders, orthopedic problems, Alcohol/Drug abuse, sleep disorders, Chromium exposure, Respirator Clearance, Blood Borne Pathogens, etc. Contacting physician's to obtain specific information to assure that the employee meets DOT regulations.

Review DME & Medical prior authorization requests for either approval or denial based on medical necessity per Medicaid guidelines. Answer phones and do some data entry of the prior authorization requests. Some manual pricing of Medical claims and Medicaid transplant claims.

Did U.M. for State Farm Files in the P.I. P. Department. Generating authorizations based on Medical Need and Necessity related to motor vehicle accidents with-in the guidelines