Motivated Interventional Radiology Nurse offering 9+ years' experience providing exceptional treatment and compassionate care to patients. A supportive champion with experience in various invasive radiological procedures. Skilled and composed with a caring attitude.
• Review, examine, investigate, and analyze workers' compensation claims.
• Interact with injured employees to ensure awareness and understanding of the workers' compensation process, requirements, and entitlements.
• Prepare and issue notices in accordance with mandated requirements and regularly review and stay abreast of applicable laws that may impact how claims are processed.
• Establish claim reserve levels by estimating the cost of each assigned claim; monitor reserves and update amounts as necessary.
• Coordinate medical treatment for injured employees and provide information to treating physicians regarding employee's medical history, health issues, and job requirements.
• Identify subrogation potential and pursue the process of reimbursement.
• Serve as a liaison between medical providers, employees and legal professionals. Inform departments of an injured employee's work restrictions and coordinate appropriate accommodations.
• Review and interpret doctor's reports to ensure that the appropriate American Medical Association (AMA) guidelines have been applied when reporting disability, impairment, and apportionment.
• Compare and reconcile claim records to ensure timely and accurate benefit payments; retrieve workers' compensation usage information from the financial system, review timesheets, and resolve discrepancies.
• Communicate with defense attorneys regarding litigated cases; make recommendations regarding proposed strategies for claim resolution.
• Prepare legal documents for submission to the Workers' Compensation Appeals Board, attend Board hearings, and respond to requests for clarification, as necessary.
• Analyze, compute, and process indemnity payments. Audit incoming invoices for accuracy and process payments.
•Develop and maintain internal systems for data collection and entry, financial analysis, and report generation; create and update spreadsheets, logs, and diary as necessary.
• Attend and participate in staff meetings and keep supervisor informed of status on all assigned cases and plan of action. Stay abreast of new trends, pending legislation, and case law related to workers' compensation.
• Perform related duties as required.
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