RN Workers Comp Coordinator
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CHI Health Clinic
Omaha, NE, US
Summary
The RN Workers Comp Coordinator manages Workers' Compensation programs by coordinating patient care and serving as a liaison between healthcare providers, insurance adjusters, and attorneys. They are responsible for obtaining medical authorizations, maintaining tracking systems for charges, and ensuring timely communication of patient medical information.
Job Description
Where You’ll Work
From primary to specialty care, as well as walk-in and virtual services, CHI Health Clinic delivers more options and better access so you can spend time on what matters: being healthy. We offer more than 20 specialties and 100 convenient locations; with some clinics offering extended hours.
Job Summary and Responsibilities
As our RN Workers Comp Coordinator, you will manage the Workers' Compensation programs for CHI Health Orthopedics which includes coordinating care for Workers' Compensation patients. Serves as a liaison between healthcare personnel, nurse case managers, rehabilitation professionals, personnel representatives, claims adjusters, attorneys, and patients for individuals who are disabled due to an injury or illness. Assists in the medical and legal aspects of Workers' Compensation working with claims adjusters, nurse case managers, and attorneys. Meets with companies, nurse case managers, and insurance adjusters to expand the business of CHI Health Orthopedics.
- Screen telephone calls for Workers' Compensation new appointments to include gathering demographic data, obtaining prior medical records and verifying insurance coverage for the scheduled appointment.
- Obtains approval or authorization for additional testing and surgical procedures by working with nurse case managers and insurance claims adjusters. Obtain approval by the Work Comp insurance carriers of all WC surgeries that are performed by the surgeons in our department. (Upon receiving the written authorization for the procedure it will be given to the medical provider's surgery scheduler who will schedule the approved procedure.)
- Facilitates collection of pertinent patient medical records with a summary letter from the assigned nurse case manager or insurance claims adjuster to forward to the appropriate orthopedic surgeon for review of a second opinion. Obtain the x-ray and MRI CD's on medical records requests and send to the requesting party.
- Prepare and maintain a tracking system for outstanding charges and pre-payment charges for narrative reports, record reviews, and etc. for Workers' Compensation and personal injury patients.
- Communicate with nurse case managers, insurance claims adjusters, and human resource personnel to ensure that all information (dictation, work restriction releases, etc.) for Workers' Compensation patients are received in a timely fashion.
Job Requirements
Required:
- Current Registered Nurse (RN) license that allows you to practice in our state
- Graduate of an accredited nursing program
- Experience in occupational health nursing and case management strongly preferred
