Job Description
Job Description: **Part time 20 hours per week
*Fully virtual role - hours are flexible
*Max payrate of ...
*Current RN licensure required and required to be maintained throughout length of assignment
Required
· Moderate knowledge of computer systems - computer literacy.
· Strong written/verbal communication.
· Current RN licensure
· 4 years of experience as an RN
· Disability claims experience or worker's comp claims experience
· Possess strong knowledge of medical conditions, symptoms, and terminology.
Preferred
· BSN
· 7 years Disability claims and/or clinical experience.
· Preferred designations CCM (certified case management) and/or CDMS (certified disability management specialist).
Job Description:
Role Value Proposition:
At ***, we seek to make a meaningful impact in the lives of our customers and our communities. The Global Technology & Operations group (GTO) is a diverse team of engineers, developers, business analysts, claims analysts and project managers with the freedom to create innovative and solutions to address core business challenges with ***. This role will work with claimants, physicians, employers, and customers to ensure strict adherence in determining functional abilities.
Key Responsibilities:
· Provides professional medical, technical, consulting advice, and recommendations in support of claims evaluation, investigation and assessment for various claims-related departments, while managing assigned caseload of complex case applying specialized training and knowledge to the assessment of cases and acting as a resource on clinical and technical issues.
· Conducts complex research, review and analysis of medical records, treatment plans and claim information.
· Provides recommendations regarding claimants current potential functional abilities.
· Engages claimants, healthcare providers, employers and customers to ensure strict adherence in determining functional abilities.
· Creates effective requests for medical information which focus on clarifying medical restrictions and limitations and their impact on work functionality.
· Performs other related duties as assigned or required
Apply Now