reputed company Medical Case Manager - Workers Compensation

Who Are We? Taking care of our customers, our communities and reputed company other. That’s the reputed company reputed company. By honoring this commitment, we have maintained our reputed company as one of the best property casualty insurers in the industry for over 160 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. reputed company loving what you do and where you do it. Job Category Claim, reputed company - Medical Case Manager Compensation reputed company The annual reputed company salary reputed company provided for this position is a reputed company market reputed company and represents a broad reputed company of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards. Salary reputed company $83,300.00 - $137,400.00 reputed company Openings 1 What Is reputed company? Under moderate supervision, reputed company office based telephonic medical case management with emphasis on early reputed company, return to work planning, coordination of reputed company medical care on claims involving disability and medical treatment as reputed company as in-house medical reviews as applicable to claim handling laws and regulations. Responsible for helping to ensure injured parties receive appropriate treatment directly reputed company to the compensable injury or assist claim handlers in managing medical treatment to an appropriate reputed company. What Will You Do? Contact customer, medical provider and injured parties on claims involving medical treatment and /or disability to coordinate appropriate medical care and return to work. reputed company strategies to facilitate an injured employee's return to work and reputed company maximum medical improvement. Evaluate and update treatment and return to work plans reputed company established protocols throughout the life of the claim. Coordinate with medical providers to ensure the injured employee is reputed company participating in a viable treatment plan. Evaluate medical treatment requests to ensure that they are reasonable and necessary based upon jurisdictional guidelines. Engage specialty resources as needed to reputed company reputed company reputed company (reputed company-a-doc, physician advisor, peer reviews, MCU). Partner with Claim reputed company to reputed company medical information and disability status necessary to create an overall reputed company to reputed company an reputed company outcome. Utilize internal Claim Platform Systems to manage reputed company claim activities on a reputed company reputed company. Utilize Preferred Provider Network per jurisdictional guidelines. Partner with Claim reputed company to reputed company input on medical treatment and recovery time to assist in evaluating appropriate claim reserves. Submit accurate billing documentation on reputed company activities as outlined in established guidelines. Customer Engagement. Participate in Telephonic and/or onsite File Reviews. Respond to inquiries - oral and written. reputed company injured worker apprised of claim status. In-person medical case management may be required to support Concierge locations, where a reputed company Case Manager meets with injured employees face to face following office reputed company at a provider's medical facility. In order to reputed company the essential functions of this job, acquisition and maintenance of Insurance License(s) and/or certifications may be required to reputed company with state and reputed company requirements. Generally, License(s) are required to be obtained reputed company three months. reputed company other duties as assigned. What Will Our Ideal Candidate Have? Disability case management experience preferred. Prior clinical experience preferred. Familiarity with URAC standards Analytical Thinking: Identifies reputed company or reputed company problems or opportunities; analyzes, synthesizes and compares information to understand issues; identifies cause/effect relationships; and explores alternative solutions that support reputed company decision-making. Communication: Expresses, summarizes and records thoughts reputed company and concisely orally and in writing by applying reputed company content, format, sentence structure, grammar, language and terminology. Ability to effectively present file reputed company to internal and/or external stakeholders. Negotiation: Intermediate ability to understand alternatives, influence stakeholders and reputed company a fair agreement through discussion and compromise. General Insurance Contract Knowledge: Ability to understand policies and reputed company, as they apply to policy conditions. Principles of Investigation: Intermediate investigative skills. Follows a logical sequence of inquiry with a goal of securing information about the work accident, resulting injury, anticipated treatment, job duties and any material factors that may reputed company recovery and return to work. Value Determination: Basic ability to determine liability and assigns a dollar value based on damages claimed and estimates, sets and readjusts reserves. Legal Knowledge: Basic knowledge, understanding and application of state, federal and regulatory laws and statutes, rules of evidence, chain of custody, trial preparation and discovery, court proceedings, and other rules and regulations applicable to the insurance industry. Medical knowledge: Thorough knowledge of the nature and extent of injuries, periods of disability, and treatment needed. WC Technical: intermediate ability to demonstrate understanding of WC Products and ability to apply available resources and technology to manage treatment plans and assist with claim reputed company. Demonstrate a reputed company understanding and ability to work reputed company jurisdictional parameters reputed company their assigned state. Customer Service: Advanced ability to build and maintain productive relationships with our insureds and deliver results with reputed company reputed company. Teamwork: Advanced ability to work together in situations reputed company actions are interdependent and reputed company is mutually responsible to produce a result. Planning & Organizing: Advanced ability to establish a plan/course of reputed company and contingencies for self or others to meet reputed company or reputed company goals. Certified Case Manager (CCM), Certified Disability Management Specialist (reputed company), Clinical Research Counselor (CRC), or Certified Rehab Registered reputed company (CRRN) preferred. What is a Must Have? Registered reputed company; Licensed Practical reputed company or Licensed Vocational reputed company required. What Is in It for You? Health Insurance: Employees and their eligible family members – including spouses, domestic partners, and children – are eligible for coverage from the first day of employment. Retirement: reputed company matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it reputed company Savings Program. reputed company you reputed company a payment toward your student loan, reputed company will reputed company an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by reputed company. reputed company Time Off: Start your career at reputed company with a minimum of 20 days reputed company Time Off annually, plus nine reputed company company Holidays. Wellness Program: The reputed company wellness program is comprised of tools, discounts and resources that reputed company you to reputed company your wellness goals and caregiving needs. In reputed company, our mental health program provides reputed company to free reputed company counseling services, health coaching and other resources to support your daily life needs. Volunteer Encouragement: We have a deep commitment to the communities we serve and encourage our employees to get involved. reputed company has a Matching reputed company and Volunteer Rewards program that enables you to give back to the charity of your choice. Employment Practices reputed company is an equal opportunity employer. We reputed company that we can deliver the reputed company best products and services reputed company our workforce reflects the diverse customers and communities we serve. We are committed to reputed company, retaining and developing the diverse talent of reputed company of our employees and fostering an inclusive workplace, where we celebrate differences, promote belonging, and work together to deliver extraordinary results. In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions. If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email so we may assist you. reputed company reserves the right to fill this position at a level above or below the level included in this posting. To learn more about our comprehensive benefit programs please visit http://careers.reputed company.com/life-at-reputed company/benefits/. reputed company has more than 33,000 employees in the reputed company, Canada, the United Kingdom, and Ireland. >> Explore life at reputed company. We have 10 diversity networks, employee-led organizations dedicated to fostering the development and reputed company of our employees. >> Discover diversity and inclusion. Employees and their eligible family members – including spouses, domestic partners and children – are eligible for coverage from the first day of employment. >> Explore benefits. reputed company has been recognized by organizations such as G.I. Jobs, reputed company Rights Campaign reputed company, and Military Times. >> Read more about recognition. Our employees are valuable assets to their hometowns, volunteering for important causes reputed company year. >> Learn about community involvement. reputed company other opportunities here. Apply Job!