RN Workers Comp Coordinator

CommonSpirit Health; Omaha (NE); On-site; USD 65,000 - 90,000; Full time

Job summary

CommonSpirit Health's CHI Health Orthopedics is seeking an RN Workers' Comp Coordinator to manage the workers' compensation programs and coordinate care for WC patients.

You will serve as a liaison among healthcare personnel, nurse case managers, insurance adjusters, attorneys, and patients, facilitate approvals for tests and surgeries, collect medical records, and maintain a tracking system for charges and narratives.

Qualifications

• RN license in applicable state.
• Graduate of an accredited nursing program.
• Experience in occupational health nursing and case management preferred.

Responsibilities

• Manage Workers' Compensation programs for CHI Health Orthopedics.
• Act as liaison between healthcare staff, nurse case managers, insurance adjusters, attorneys, and patients.
• Obtain approvals for additional testing and WC surgeries by coordinating with insurers and providers.
• Collect and forward medical records and prepare summary letters for review by orthopedic physicians.
• Maintain tracking for charges and pre-payments for narrative reports and record reviews.

Skills

RN license

Occupational health nursing

Case management

Medical records coordination

Education

Graduate of an accredited nursing program

Job description

Job Summary and Responsibilities

As our RN Workers Comp Coordinator, you will m 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

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.