Health Care Professional – Workers Compensation, RN, DC, PT, DPT, LVN, OT, LAc

This is a fully remote position, open to applicants in Nevada.

📋 Description

• Conduct a thorough assessment of medical data for service requests.

• Gather additional pertinent information as necessary to determine medical necessity.

• Evaluate the gathered data utilizing evidence-based guidelines relevant to the jurisdiction of the claim.

• Collaborate with insurance representatives to discuss the analyzed data and comprehensive care plans as required.

• Inform providers, requesters, claimants, carriers, and other mandated parties regarding decisions.

• Facilitate communication among injured workers, physicians, employers, therapists, attorneys, and other stakeholders.

• Engage in annual work-product audits to ensure adherence to compliance standards.

• Maintain professional interactions with EKHS staff, members of the medical community, and customers in both verbal and written formats.

• Partake in teleconferences, scheduled staff meetings, and training sessions.

• Carry out additional responsibilities as assigned.

⛳️ Requirements

• Graduate from an accredited nursing, chiropractic, or another related medical program (RN, DC, PT, DPT, LVN, OT, LAc).

• Hold a valid state-specific license in the relevant scope of practice, in good standing with no restrictions.

• Demonstrate the required professional and technical skills effectively.

• Experience in Utilization Review; prior experience in Workers' Compensation is highly preferred but not mandatory.

• Exceptional written and oral communication skills.

• Strong interpersonal skills.

• Excellent organizational abilities.

• High proficiency with computers and software programs (MS Word, MS Excel, Email).

• Ability to work independently with minimal oversight.

• Capability to meet deadlines in a high-pressure, time-sensitive environment.

• Ability to lift up to 20 lbs.

• Must be able to sit for the majority of an 8-hour workday, except during lunch and break times.

• Must be able to type for the majority of an 8-hour workday, except during lunch and break periods.

• Must possess manual dexterity.

• Must be able to speak on the phone intermittently throughout the day.

• Must be able to read and write fluently in English.

• Must ensure a safe home office environment.

• Home office must comply with HIPAA regulations.

• Requires DSL, fiber, or cable internet connection from home; 100 Mbps or better is preferred.

• Applicants must not reside in California, New York, or Hawaii.

🏝️ Benefits

• Medical, Dental, and Vision insurance.

• 401K.

• Paid Time Off.

• Paid Holidays.

• Monthly Internet Stipend.

• Remote work opportunity.