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Rising Medical Solutions

Rising Medical Solutions is an insurance company that is on a mission to find solutions for the financial challenges people face regarding medical needs. As an employer, Rising Med

Triage Nurse - Remote

Location

Illinois

Posted

101 days ago

Salary

0

Seniority

Mid Level

English

Job Description

Triage Nurse - Remote

Rising Medical Solutions

As our Triage Nurse, you will be responsible for conducting a focused assessment and prioritizing a patient’s clinical condition to provide immediate care if the patient requires it. Core Responsibilities include: - Assess injury severity, the extent of disability, treatment plans, functional abilities, and physical job requirements. - Utilize sound clinical judgment, careful listening, and critical thinking and assessment skills. - Assign files appropriately to an Injury Coordinator or a TCM, based on the injured worker’s needs. - Assist with tracking high-risk, high cost and complex patients by assessing the injured/disabled individual’s needs. - Post case facts in Rising’s system, as well as the client’s claims system when appropriate. - Assist non-clinical staff by reviewing files and recommending an action plan. - Provide care direction and/or assist the injured worker in finding a provider when appropriate. - Establish collaborative relationships and work as an intermediary between clients, patients, employers, providers, and attorneys. - Adhere to quality standards along with state and national standards and guidelines - Locate and document appropriate evidence-based and return-to-work guidelines (e.g., ODG). - Promote quality, cost-effective care throughout the health continuum to ensure the injured/disabled individual can return to an optimal level of work and functioning. - Advise the supervisor of any potential problems as they become evident. - Maintain in-depth knowledge of all company products and services as well as customer issues and needs through ongoing training and self-directed research. - Continuous professional development about issues and trends in case management. - Provide input for policies/procedures, as requested. - Adhere to departmental case management standards and guidelines, as well as Company policies, procedures, and reporting requirements. - Perform other administrative or corporate duties upon request Reports to: Rising Ultimate Nurse Case Manager

Job Requirements

  • Active appropriate professional nurse license (RN or LPN) in the state of residence
  • Minimum of 1-year clinical nursing experience required
  • Prior remote/telephonic work experience preferred
  • Being bilingual in Spanish is a plus
  • Prior triage experience preferred
  • Experience with Workers’ Compensation, short-term or long-term disability, or liability claims preferred
  • Bill review experience with Workers’ Compensation, Auto, and/or Health Insurance carriers a plus
  • Flexibility in working both autonomously and on a team
  • Maintain confidentiality of all information, policies, and procedures
  • Demonstrate sensitivity to culturally diverse people and situations
  • Well-developed time-management, organization, and prioritization skills
  • Knowledge of utilization management, case management, and healthcare provided throughout the health continuum
  • Excellent oral and written communication skills, over the phone and interpersonal
  • Ability to gather data, compile information and, prepare summary documentation
  • Strong interpersonal and customer service skills
  • Experience in a fast-paced, multi-faceted environment
  • Demonstrated persistence and attention to detail
  • Working knowledge of internet research/navigation, Microsoft Word, Excel, and Outlook
  • Ability to remain calm during stressful situations
  • Customer-service oriented
  • Working Conditions:
  • Remaining in a seated position
  • Entering text or data into a computer
  • Visual Acuity
  • Talking
  • Hearing
  • Repetitive arm, hand, and finger motion
  • Working remotely some or all of the time

Benefits

  • Health insurance (6 different plans to choose from)
  • Dental
  • Vision
  • Paid time off (PTO) or Flexible Time Off (FTO)
  • 401(k)
  • Basic Life Insurance and Long-Term Disability Insurance (paid by the company)
  • Voluntary Life Insurance and Short-Term Disability Insurance
  • Flexible Spending Accounts (FSA)
  • Employee Assistance Program (EAP)
  • Rise Well Wellness Program
  • Professional Development Reimbursement Program (PDRP)
  • You will be part of our new Elevate program designed to recognize and reward employees for their hard work

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Job Closed