Nurse Case Coordinator
About the position
As a Nurse Case Coordinator at Erie Insurance, you will play a crucial role in ensuring that all aspects of an injured party's medical treatment are appropriate, cost-effective, and efficient, while also adhering to applicable legal requirements. This position is designed for individuals who are committed to providing high-quality medical consultation and education to claims personnel, as well as assisting the Medical Consultant in their duties. You will be working from home within Eries footprint, which allows for flexibility while still being part of a larger, diverse team that values inclusivity and service excellence. In this role, you will be responsible for identifying inappropriate, experimental, overutilization, or costly medical treatments. You will review precertification requests for medical necessity and refer those that require additional expertise to the Medical Consultant. Compliance with individual state legislation is essential, and you will need to stay updated on relevant laws and regulations to ensure that all medical treatments align with legal standards. Your expertise will be vital in providing guidance and support to claims personnel, helping them navigate complex medical cases effectively. The position may require occasional travel for meetings, training, and other professional development opportunities. As a member of the Corporate Claims Department, you will contribute to the overall mission of Erie Insurance, which is to be Above all in Service® to both customers and employees. This role not only offers a competitive salary range but also the potential for an annual bonus payment, reflecting the companys commitment to rewarding its employees for their hard work and dedication.
Responsibilities
Identifies inappropriate, experimental, overutilization or costly medical treatment.
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Reviews precertification requests for medical necessity, referring those that require additional expertise to the Medical Consultant.
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Complies with individual state legislation regarding medical treatment and claims processing.
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Provides medical consultation and education to claims personnel.
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Assists the Medical Consultant in their duties.
Requirements
Registered Nurse (RN) license in the state of residence.
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Experience in case management or a related field.
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Strong understanding of medical terminology and treatment protocols.
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Excellent communication and interpersonal skills.
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Ability to work independently and manage time effectively.
Nice-to-haves
Certification in case management (CCM) or similar credentials.
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Experience in the insurance industry, particularly in claims management.
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Familiarity with legal requirements related to medical treatment and claims.
Benefits
Premier health, prescription, dental, and vision benefits for you and your dependents.
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Low contributions to medical and prescription premiums, with the company covering up to 97% of employees' monthly premium costs.
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Traditional pension plan, with full vesting after five years of service.
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401(k) with up to 4% contribution match.
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Paid time off including vacation, personal days, sick days, bereavement days, and parental leave.
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Tuition reimbursement program for higher education and industry designations.
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Company-paid basic life insurance and short-and long-term disability insurance.
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Orthodontic coverage for children and adults.
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Adoption assistance and fertility coverage.
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Well-being programs and paid volunteer hours for community service.
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Dollar-for-dollar matching of charitable gifts each year.
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