Road to Recovery: 5 People Who Join You on Your Claims Journey

April 19, 2023 • Previsor

A workplace incident can be an intimidating experience for employers. Property damage and injured workers may be a result of the situation. Not only will there be paperwork to complete, but questions to answer as well.  

At Missouri Employers Mutual and Previsor Insurance, our goal is to help employees get the care they need while keeping costs in check. This means walking together with employers through a claim, every step of the way.  

Here are five people employers may encounter during a work comp claim – and their role in getting workers back on the job sooner. 

Claims Services Representative 

A Claims Services Representative is one of the first professionals an employer will encounter after an incident is reported. They will collect information, assess evidence and witness statements, and authorize payments where necessary. Claims Representatives are in contact with employers during the entire claims process.  

Field Service Manager 

A Field Services Manager (FSM) joins a claim when a Claims Services Representative needs more insight into the incident scene. An employer should collect as many details as they can in the hours and days following a workplace incident. An FSM visits a business to understand more about its operations, take pictures and videos, and talk to any witnesses.  

Their professional experience allows them to tap into additional sources of information, such as local surveillance cameras, that may help resolve the claim. Their insight can also lend a hand in cases of subrogation, where a third party bears some fault in causing an incident. 

Nurse Case Manager 

A Nurse Case Manager (NCM) is a medical professional who will guide the medical aspects of a claim. They coordinate appointments, track the recovery process, and communicate with members of the medical care team. Much of this work is done by telephone. However, depending on the type and severity of the claim, NCMs will join injured workers in-person.  

Primary Care Provider  

A primary care provider is a doctor who oversees an injured worker’s treatment. They will identify the injury type, make referrals for specialty care, and prescribe medication. Claims Services Representatives and Nurse Case Managers will regularly communicate with them during the recovery process. Their professional recommendation will determine when and in what capacity an injured worker can return to the job.  

Return to Work Coordinator 

Return to work coordinators assist injured workers and employers with solutions that accommodate recovery and allow for productivity. Returning to work can positively affect an employee’s morale and financial situation and reduce claims costs. Light duty provides opportunities to work on simpler and less strenuous tasks during recovery.  For example, working at a non-profit organization. 

April 19, 2023
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