About InSpectre Solutions, Inc

Built on integrity, expertise, and unparalleled professionalism, InSpectre Solutions International is a full-service investigative and medical case management agency specializing in international worker’s compensation, Defense Base Act, war hazard claims in over 150 countries.

InSpectre Solutions is an Equal Opportunity Employer and makes all employment decisions without regard to race, religion, color, sex (including pregnancy, sexual orientation, and gender identity), national origin, disability, age, genetic information, or any other status protected under applicable federal, state, or local laws.

About the role

(Only accepting applications from candidates residing in states within the Eastern Time Zone (EST))

Using discretion and independent judgment, the Nurse Case Manager (NCM) position is responsible for reviewing medical legal records, understanding the diagnoses, treatment plan, treatment possibilities, medications, and offering an assessment of care and expected needs towards recovery.

What you'll do

• Maintain and manage claims with field agents and managers, to ensure claims remain up to date with relevant information.
• Have up-to-date knowledge of the worker’s compensation system
• Coordinate care between the claimant, providers, ancillary providers, attorney and the account holder.
• Provide regular weekly/monthly updates for the client
• Complete medical reviews and tasks in a timely manner
• Ensure the claim narrative is up to date with accurate and relevant information that captures time, expenses, and appropriately reflects the services performed
• Review claims, reports, requests, and invoices weekly
• Performs other duties relevant to claims as required/necessary.

Reports to: Senior Director of Nurse Case Management

Direct Reports: N/A

Qualifications

• Nursing degree required
• Active compact RN license required
• Experience in the general field of nursing such as hospital nursing, rehabilitation, occupational medicine, and clinical settings which interact with the patients and providers
• Team player who is highly motivated and extremely organized.
• Excellent communication skills, both written and verbal.
• Able to act as a resource for other team members for medical, treatment, and rehabilitation issues.
• Self-starter who works independently and at the same time reaches out to co-workers as needed to seek assistance, share thoughts, and offer expertise.
• Clear report writing skills.
• Bilingual in any language a PLUS