Associate Claims Clinical Specialist

Responsibilities Reviewing clinical assessments completed by field assessors to determine chronic illness status and develop a plan of care with supporting written documentation. Collaborate with field assessors and facility staff via phone to determine if further information is needed on a claimant or member’s health status. Call claimants, family members or facility staff to update records on their present health status and provide a new plan of care, as well as handle telephonic assessments. Work with new clients to develop processes that meet their insureds’ needs. Requirements RN with a current license residing in a Nursing License Compact state with licensure in their residential state and a Nursing Compact License A minimum of 3 years of professional clinical experience in case management, home care, or a rehabilitation setting, preferably with a geriatric population Strong knowledge of Microsoft applications to include Outlook and Word. Proficient with workflow management tools and CRM Ability to handle inbound and outbound calls with claimants, family members, facilities and agencies Excellent computer, data input and technical skills including working with multiple screens. Bilingual is nice to have #J-18808-Ljbffr