Registered Nurse Program Coordinator, Workers’ Compensation

State of Louisiana; Baton Rouge (LA); On-site; USD 70,000 - 98,000; Full time

Job summary

Louisiana Works is seeking a Registered Nurse-Program Coordinator in Baton Rouge to oversee medical services and MTG dispute resolution within the OWCA framework.

The role requires RN licensure with 3+ years of experience (or equivalent combinations) and knowledge of medical terminology, regulatory compliance, and claims review. Collaboration with providers and state agencies is essential; drug screening and background check are required.

Qualifications

• Must be a licensed registered nurse with relevant clinical experience.
• Experience with workers’ compensation or medical claims review is a plus.

Responsibilities

• Analyze and review all claims, medical records, and documentation to evaluate the necessity, appropriateness, and level of medical services provided.
• Contact and confer with providers, carriers, and other entities to obtain additional documentation such as progress reports, operative reports, and procedure codes.
• Maintain and update case files, closing them in accordance with departmental policy.
• Review and process Medical Treatment Guideline (MTG) requests, coordinating with the Medical Director to ensure timely issuance of determinations.
• Coordinate with stakeholders on matters involving medical services or disputes related to the reimbursement schedule

Skills

Nursing practice

Medical terminology

Regulatory compliance

Communication

Education

Bachelor's degree in nursing + 2 years RN exp

Master's degree in nursing or public health + 2 years RN exp

Doctorate in nursing or public health + 1 year RN exp

Three years experience as licensed RN

Job description

Louisiana Works is seeking a Registered Nurse-Program Coordinator in Baton Rouge to oversee medical services and MTG dispute resolution within the OWCA framework.

The role requires RN licensure with 3+ years of experience (or equivalent combinations) and knowledge of medical terminology, regulatory compliance, and claims review. Collaboration with providers and state agencies is essential; drug screening and background check are required.