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Health Care Professional – Workers Compensation, RN, DC, PT, DPT, LVN, OT, LAc
EK Health Services Inc.. Perform a complete evaluation of medical data for service requests .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in medical data evaluation and analysis, ensuring compliance with evidence-based guidelines and effective communication with various stakeholders. Proficient in managing information flow among healthcare professionals and maintaining a HIPAA-compliant home office environment.
Highest-signal resume keywords
Registered Nurse (RN) LicenseWorkers' Compensation ExperienceMedical Data AnalysisExcellent Written And Oral Communication SkillsStrong Organization Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Medical Data EvaluationEvidence-Based Guidelines AnalysisData CollectionCompliance AuditsManual Dexterity
Soft Skills
Excellent Interpersonal SkillsAbility To Work IndependentlyAbility To Meet Deadlines
Tools & Technologies
MS WordMS ExcelEmail
Certifications & Qualifications
Valid State-Specific License
Industry Keywords
Utilization Review (UR)HIPAA ComplianceTeleconferencesHealthcare Coordination
About the role
Key responsibilities & impact- Perform a complete evaluation of medical data for service requests
- Collect additional relevant data as needed to decide medical necessity
- Analyze collected data using evidence-based guidelines applicable to the claim's jurisdiction
- Discuss analyzed data and comprehensive care plans with insurance representatives as needed
- Notify providers, requesters, claimants, carriers, and other mandated parties of decisions
- Coordinate information among injured workers, physicians, employers, therapists, attorneys, and other parties
- Participate in annual work-product audits to ensure compliance
- Interact professionally with EKHS staff, medical community members, and customers in oral and written forms
- Participate in teleconferences and scheduled staff meetings and trainings
- Perform other duties as assigned
Requirements
What you’ll need- Graduate of an accredited school of nursing, chiropractic, or another related medical program (RN, DC, PT, DPT, LVN, OT, LAc)
- Valid state-specific license in the appropriate scope of practice in good standing with no restrictions
- Possesses and can demonstrate the professional and technical skills required
- Experience in UR; Workers' Compensation experience highly preferred, but not required
- Excellent Written and Oral Communication Skills
- Excellent Interpersonal Skills
- Strong Organization Skills
- High comfort level with computers and computer programs (MS Word, MS Excel, Email)
- Ability to work independently with minimal supervision
- Ability to meet deadlines in a high pressure, time sensitive environment
- Ability to lift up to 20 lbs.
- Candidate must be able to sit the majority of an 8-hour day except for lunch and break times
- Candidate must be able to keyboard the majority of an 8-hour day except for lunch and break times
- Candidate must have manual dexterity
- Candidate must be able to speak on the telephone intermittently throughout the day
- Candidate must be able to read and write English fluently
- Candidate must be able to provide and confirm a safe home office environment
- Home office must be HIPAA compliant
- Requires DSL, fiber, or cable internet connection from home; 100 Mbps preferred or better
- Applicants must not reside in California, New York, or Hawaii
Benefits
Comp & perks- Medical, Dental and Vision insurance
- 401K
- Paid Time Off
- Paid Holidays
- Monthly Internet Stipend
- Remote work