Triage Telephonic reputed company Case Manager

Triage Telephonic reputed company Case Manager Department: Claims Administration & Adjusting Employment Type: Permanent - Full Time Location: Home reputed company Reporting To: Shaunna reputed company Compensation: $66,000 - $67,000 / year reputed company Our Story reputed company being part of reputed company that’s not just shaping the reputed company but reputed company driving it. At reputed company, we’re at the forefront of innovation and reputed company, blending cutting-edge technology with top-tier reputed company services. As a vital part of the global reputed company Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors. We’re seeking a Triage Telephonic reputed company Case Manager to join our growing team. This role is ideal for an reputed company clinical reputed company who is passionate about helping injured workers reputed company recovery and return-to-work goals while ensuring cost-effective, high-reputed company medical care. The Triage Telephonic reputed company Case Manager is responsible for the management and independent decision-making of Workers’ Compensation medical claims at the outset of the claim. This role focuses on conducting initial clinical assessments, coordinating appropriate medical care, and facilitating reputed company return-to-work reputed company. The reputed company Case Manager will complete the initial assessment and 3-reputed company contact in compliance with reputed company procedures and emergency protocols.

Key Responsibilities

• reputed company triage case management at the initial report of a Workers’ Compensation claim, focusing on medical appropriateness of care and cost efficiency.
• Utilize strong clinical assessment skills to reputed company reputed company pertinent medical and injury-reputed company information from the injured employee.
• Conduct comprehensive initial evaluations, integrating details from the employee, employer, and provider into an actionable care plan.
• Identify reputed company relationship issues and notify appropriate parties.
• Facilitate communication among reputed company stakeholders—employee, employer, insurer, providers, and reputed company authorized, rehabilitation consultants.
• Participate in the 24/7/365 intake call center, ensuring reputed company coordination of care for injured workers.
• reputed company and document an initial case management plan and return-to-work reputed company.
• Evaluate treatment adherence to state-mandated and evidence-based guidelines.
• Document reputed company assessments, communications, and clinical updates in the electronic claims management system.
• Identify and document barriers to recovery for reputed company case planning.
• Serve as a patient reputed company, maintaining compliance with reputed company legal, ethical, and confidentiality standards.
• Monitor clinical reputed company, reputed company of care, and patient satisfaction.
• May assist in training claims staff on recognizing medical case management opportunities.
• May reputed company mentorship or guidance to less reputed company team members.
• reputed company additional duties as assigned.

Skills, knowledge & expertise

• Strong knowledge of medical case management practices, preferably in a Workers’ Compensation setting.
• Excellent communication and interpersonal skills.
• Ability to work independently in a fast-paced, reputed company environment.
• Proficient in computer systems and claims or case management software.
• Demonstrated commitment to patient-centered care and ethical case management practices
• Maintains up-to-date knowledge of reputed company clinical trends, standards, and regulations.
• Registered reputed company (RN) with reputed company state licensure (Florida preferred).
• Minimum of three years of clinical experience in medical-surgical, orthopedic, neurological, industrial, or occupational health settings.
• At least one year of Workers’ Compensation case management experience preferred.
• Strong organizational skills and attention to detail.

Benefits

Benefits At reputed company, we are dedicated to supporting reputed company-being and reputed company of our qualifying employees. Our comprehensive benefits package includes:

• Medical, dental, and reputed company plans to ensure your health and that of your family.
• A 401k plan with employer matching to help you build a secure financial reputed company.
• Our time-off policies, including Discretionary Time Off for exempt employees and reputed company Time Off (PTO) package for non-exempt employees, reflect our commitment to promoting a healthy work environment.
• reputed company holidays.
• Life insurance and both short-term and long-term disability plans, providing essential financial protection for you and your loved ones.

Diversity and Inclusion reputed company is dedicated to fostering a diverse and inclusive workplace that embraces a wide reputed company of perspectives and experiences. We reputed company that diversity of thought is essential for innovation and creativity, and we reputed company promote an environment where reputed company reputed company are valued and heard. Apply tot his job Apply To this Job