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Based in Atlanta, Georgia, Crawford & Company () is the world's largest independent provider of claims management solutions to the risk management and insurance industry as well as self-insured entities, with a global network of more than 700 locations in 63 countries. The Crawford System of Claims SolutionsSM offers comprehensive, integrated claims services, business process outsourcing and consulting services for major product lines including property and casualty claims management, workers' compensation claims and medical management, and legal settlement administration. The Company's shares are traded on the NYSE under the symbols CRDA and CRDB.
This a seasonal hourly 'in office' position with potential for regular full-time hours. Summary of Role:
Coordinates and medically manages a range of health care services to designated clients through telephonic communication with patients, employers, providers, adjusters, and others to determine if treatment is medically necessary, appropriate, and effective, and to secure a timely return to work status for the patient.
Responsibilities:- Communicates effectively with providers, patients, Peer Physicians, case managers and others involved in the Case management process as needed.
- Collaborates effectively to promote the integration of all Departments and products through interdepartmental referrals and communication.
- Plans and organizes individual caseload to meet URAC, jurisdictional and Best Practice Standards for timeliness, notification and documentation requirements.
- Utilizes appropriate desktop resources to perform the case management process, this includes but is not limited to the Presley Reed Medical Disability Advisor (MDA), ACOEM, Jurisdictional Database, National Account Bulletin, PPN Network Database, Screen Scrape tool.
- Analyzes medical information and applies evidenced based established guidelines to facilitate the case management process.
- Documents pertinent information in the case file notes to support case management interventions and case resolution.
- Researches, reviews and prepares medical information to present and collaborate objectively with Peer Physicians in order to facilitate case resolution.
- Promotes excellence of the case management product by participation in the QA process and through active participation in the Department's process improvement efforts.
- Independently approaches problem resolution by appropriate use of research and resources.
- Precept new staff within the department as requested.
- Demonstrates excellent customer service, and respect for customers, co-workers, and management.
- Perform other duties as assigned.
Requirements:
- RN state licensure in good standing with the State Board of Nursing.
- CCM, CRRN, CDMS or COHN required
- Bilingual Spanish a plus
Knowledge and Skills:
- Must type 30 words per minute.
- Working knowledge of personal computers with the ability to use standard word processing software applications.
- Knowledge of advanced case management techniques. i.e., Peer review, formulation and execution of complex specialty letters.
- Ability to act as consultant on most varied, complex cases of the department.
Experience:
- Minimum of Three (3) years diverse clinical experience or prior experience in Case Management.
- Three years of Telephonic Workers' Compensation case management with ability to independently coordinate a diverse caseload ranging in moderate to high complexity.
In addition to a competitive salary, Crawford offers you: - Career advancement potential locally, nationally and internationally. Crawford & Company has more than 700 locations in 63 countries;
- On-going training opportunities through every stage of your career;
- Strong benefits package including 401k; health, dental, and life insurance; employee stock purchase plans; tuition reimbursement and so much more.
Crawford & Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V
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