Medical Case Manager - CSI
Independence Blue Cross - Philadelphia, PA

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Position Type:
Full Time

CompServices is always looking for qualified people to administer our current products, research new products and technologies, and provide our customers with the best service.

Job Summary:

The Medical Case Manager develops, coordinates, implements, manages and monitors rehabilitation plans for injured workers. Duties include:
  • Receiving telephone notifications of claims
  • Determining extent of medical treatment recommended and intervening according to established protocols
  • Reviewing cases within 24 hours
  • Entering claim info into computer and developing medical management plan
  • Monitoring and documenting quality of care and utilization of providers
  • Reviewing medical bills and verifying treatment
  • Communicating with employers regarding return to work feasibility
  • Updating Claims Adjuster on change in duty status
  • Maintaining active cases in diary, assigning pool assignments
  • Maintaining contact with providers, facilities, employers and claimants as needed

Qualifications:

  • Registered Nurse or Licensed Practical Nurse with a minimum of 2 years experience, preferably in case management, rehabilitation, orthopedics or utilization review.
  • Excellent oral and written communications skills required.
  • Knowledge of CompServices managed care programs, policies and procedures and a broad knowledge of CompServices benefits and claims provisions preferred.
  • Certification in Case Management and knowledge of Pennsylvania Workers Compensation Law also preferred but not required.

Equal Employment Opportunity

CompServices Inc. is an Equal Opportunity Employer (EOE). Qualified applicants are considered for employment without regard to age, race, color, religion, sex, national origin, sexual orientation, disability, or veteran status.

Agency Disclaimer

All resumes submitted directly to a CompServices employee from a vendor via email, the Internet or in any other form without a valid written search agreement in place for this position from the CompServices Human Resources Department will be deemed the sole property of the CompServices . Please note that no fee will be paid in the event the candidate is hired by the CompServices as a result of the referral or through means other than our established process.

Independence Blue Cross - 17 months ago - save job - block