About the role
(Accepting applications from applicants living in the continental United States Only)
Using discretion and independent judgment, the Nurse Case Manager (NCM) position is responsible for reviewing medical legal records, understanding the diagnoses, treatment plan, treatment possibilities, medications, and offering an assessment of care and expected needs towards recovery.
What you'll do
- Maintain and manage claims with field agents and managers, to ensure claims remain up to date with relevant information.
- Have up-to-date knowledge of the worker’s compensation system
- Coordinate care between the claimant, providers, ancillary providers, attorney and the account holder.
- Provide regular weekly/monthly updates for the client
- Complete medical reviews and tasks in a timely manner
- Ensure the claim narrative is up to date with accurate and relevant information that captures time, expenses, and appropriately reflects the services performed
- Review claims, reports, requests, and invoices weekly
- Performs other duties relevant to claims as required/necessary.
Qualifications
- Nursing degree required
- Active RN license
- Active Nurse Licensure Compact (NLC)
- Experience in the general field of nursing such as hospital nursing, rehabilitation, occupational medicine, and clinical settings which interact with the patients and providers
- Team player who is highly motivated and extremely organized.
- Excellent communication skills, both written and verbal.
- Able to act as a resource for other team members for medical, treatment, and rehabilitation issues.
- Self-starter who works independently and at the same time reaches out to co-workers as needed to seek assistance, share thoughts, and offer expertise.
- Clear report writing skills.
- Bilingual in any language a PLUS