Telephonic Case Manager

Ethos Risk; Phoenix (AZ); Remote; USD 50,000 - 75,000; Full time

Job summary

Ethos Risk is seeking a Licensed RN for the position of Telephonic Case Manager. This fully remote role involves reviewing claims and ensuring compliance in a supportive environment focused on uncovering facts and improving insurance processes. Ideal candidates will possess strong communication and organizational skills and have a background in managed care.

Qualifications

• Experience in a managed care or workers' compensation environment is essential.
• Strong oral and written communication skills are necessary.
• Familiarity with Microsoft Office products is required.

Responsibilities

• Review claims based on criteria and protocols for workers' compensation.
• Ensure compliance with state and regulatory agency standards.
• Identify critical details impacting medical treatments from records.

Skills

Communication

Organizational Skills

Teamwork

Critical Thinking

Discretion

Confidentiality

Multi-tasking

Initiative

Job description

Ethos Risk Services is continuing to expand our Medical Management Department - and we're looking for a Licensed RN to be part of our growing team as a Telephonic Case Manager.

Ethos Risk is one of the largest and most well-respected insurance claim processing and fraud investigations businesses in the US. Join us in uncovering the facts, keeping insurance costs from rising, and serving our clients in a fully remote position. At Ethos, you'll find more than just a job - you'll discover a purposeful career and a supportive team that celebrates high performers, values employees, and delivers results.

WHAT DOES A TELEPHONIC CASE MANAGER DO?

As a Telephonic Case Manager, you will review claims based on criteria and protocols in accordance with state and regulatory agency compliance, for workers' compensation.

WHO WE'RE LOOKING FOR :

We're seeking a self-starting, critical thinking team member to join us. Critical requirements include :

• Prior experience in a managed care or workers' compensation environment
• Strong oral and written communication skills
• Computer knowledge required, including Microsoft Office products
• Able to perform as part of a team
• Strong organizational skills and excellent people skills
• Discretion and confidentiality
• Strong ability to review medical records and identify critical details impacting medical treatments and medical necessity determinations
• Must be initiative-taking, independent, and accountable
• Strength in multi-tasking and clinical prioritization

Bonus Points If You :

• Certified Case Manager (CCM) or Certified Disability Management Specialist (CDMS)

Ethos Risk Services is an equal opportunity employer that does not discriminate on the basis of religious creed, sex, national origin, race, veteran status, disability, age, marital status, color or sexual orientation or any other characteristic protected by law.

A background check will be conducted, in accordance to the local state law and regulations.