Remote Claims Processor Jobs in Portland, OR (NOW HIRING)

If you're a registered nurse looking for a new opportunity to work in a fast-paced, professional environment where your talent contributes to our competitive edge, Liberty Mutual Insurance has the opportunity for you. Under general technical direction, responsible for medically managing assigned caseload and by applying clinical expertise ensure individuals receive appropriate healthcare in order to return to work and normal activity in a timely and cost effective manner. Caseload may include catastrophic/complex medical/disability cases, lost time, and/or medical only claims. Also act as a clinical resource for field claim partners.

This is a remote position however, you will be required to report into the office twice a month per business requirements if you reside within 50 miles of the following offices: Chandler, AZ, Suwanee, GA, Indianapolis, IN, Plano, TX, and Westborough, MA, Lake Oswego,OR. Please note this policy is subject to change. 

A High speed wired internet connection is required. Satellite internet is not supported for this position.

Responsibilities:

• Follows Liberty Mutual's established standards and protocols to effectively manage assigned caseload of medical/disability cases and by applying clinical expertise assist to achieve optimal outcome and to facilitate claim resolution and disposition.
• Effectively communicates with injured employees, medical professionals, field claims staff, attorneys, and others to obtain information, and to negotiate medical treatment and return to work plans using critical thinking skills, clinical expertise and other resources as needed to achieve an optimal case outcome.
• Utilizes the Nursing Process (assessment, diagnosis, planning, intervention and evaluation) to facilitate medical management to attain maximum medical improvement and return-to-work (RTW) per state jurisdictional requirements.
• Appropriately utilizes internal and external resources and referrals i.e., Utilization Review, Peer Review, Field Claims Specialists, Regional Medical Director Consults, and Vocational Rehabilitation to achieve best possible case outcome.
• Follows general technical direction from nurse manager, senior medical and disability case manager and/or CCMU staff to resolve highly complex medical and/or RTW issues and/or successfully manage catastrophic injuries.
• Documents all RN activities accurately, concisely and on a timely basis. This includes documenting the medical and disability case management strategies for claim resolution, based on clinical expertise. Adheres to confidentiality policy.
• Appropriately applies clinical expertise to claims and delivers services in an efficient and effective manner.
• Accurately and appropriately documents time tracking for work performed. Achieves annual time tracking goal.
• Handles special projects as assigned.
• Spanish Speaking - highly preferred

• Ability to analyze and make sound nursing judgments and to accurately document activities.
• Strong communication skills in order to build relationships with injured employees, medical professionals, employers, field claims staff and others.
• Good negotiation skills to effectively establish target return to work dates and coordinate medical care.
• Knowledge of state, local and federal laws related to health care delivery preferred.
• Personal computer knowledge and proficiency in general computer applications such as Internet Explorer and Microsoft Office (including Word, Excel and Outlook).
• Degree from an accredited nursing school required (prefer Bachelor of Science in Nursing).
• Minimum of 3 to 5 years of clinical nursing experience; prefer previous orthopedic, emergency room, critical care, home care or rehab care experience.
• Previous medical case management experience a plus.
• Must also have current unrestricted registered nurse (R.N.) license in the state where the position is based and other assigned states as required by law.
• Must have additional professional certifications, such as CCM, COHN, CRRN, etc., where required by WC law.

Pay Philosophy: The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Some roles at Liberty Mutual have a corresponding compensation plan which may include commission and/or bonus earnings at rates that vary based on multiple factors set forth in the compensation plan for the role.At Liberty Mutual, our goal is to create a workplace where everyone feels valued, supported, and can thrive. We build an environment that welcomes a wide range of perspectives and experiences, with inclusion embedded in every aspect of our culture and reflected in everyday interactions. This comes to life through comprehensive benefits, workplace flexibility, professional development opportunities, and a host of opportunities provided through our Employee Resource Groups. Each employee plays a role in creating our inclusive culture, which supports every individual to do their best work. Together, we cultivate a community where everyone can make a meaningful impact for our business, our customers, and the communities we serve. We value your hard work, integrity and commitment to make things better, and we put people first by offering you benefits that support your life and well-being. To learn more about our benefit offerings please visit: https://www.libertymutualgroup.com/about-lm/careers/benefitsLiberty Mutual is an equal opportunity employer. We will not tolerate discrimination on the basis of race, color, national origin, sex, sexual orientation, gender identity, religion, age, disability, veteran's status, pregnancy, genetic information or on any basis prohibited by federal, state or local law.Fair Chance Notices

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