JOB OPPORTUNITIES

RN Case Manager

CompServices has been in existence since 1992 and is an established workers’ compensation third party administrator in the Commonwealth of Pennsylvania and a Managed Care Organization (MCO) in New Jersey. As a wholly owned subsidiary of one of the largest health insurers in the eastern part of Pennsylvania, we recognize the value of providing a continuum of care within a community. Our mission and philosophy is to arrange for the provisions of prompt health care to injured employees while recognizing the dual goal of wellness and returning the employee back to active duty at the earliest medically appropriate time.

We are currently seeking RN Case Managers for our Harrisburg and Pittsburgh, PA locations.

Responsibilities

The RN case manager is responsible for:

• Developing, coordinating, implementing, managing, and monitoring rehabilitation plans for injured workers for self-insured clients;
• Receiving telephone calls from the employer, employee, cooperating emergency room, or primary network notifying of a claim;
• Determining extent of medical treatment recommended and intervening according to established protocols;
• Reviewing cases within 24 hours and entering basic claim information into the computer;
• Monitoring and documenting quality of care and utilization of provider, and reviewing cases for reasonableness and necessity of treatment, equipment, and therapies as they relate to established protocols;
• Conducting provider audits;
• Monitoring medical bills, reviewing bills, verifying treatment rendered, and facilitating flow of bills to adjuster for data entry and payment;
• Planning for injured workers’ return to employment, projecting return-to-work dates, discussing appropriate job availability with employer, and assisting in obtaining work restriction as necessary.

Qualifications

• Registered Nurse with knowledge of acute clinical care;
• Two or more years in workers’ compensation/case management;
• Proven experience with workers’ compensation laws, regulations, policies, and procedures;
• Tact, diplomacy, and professional demeanor;
• Experience interacting with medical professionals, managed care clients, and external organizations;
• Good analytical, interpersonal, communication, and marketing skills.

Contact Us

To learn more about CompServices, Inc., visit www.compservicesinc.com.  Email resume with salary requirements (please insert Code: RNCM-022808-CH in the subject line of your email) to recruiter_8@ibx.com. EOE

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