In this vital role the Nurse Case Representative medically manages the treatment of our customers injured in an automobile accident in accordance with state and company guidelines.
Essential Functions and Responsibilities
- Medically manage individual injuries by obtaining and assessing medical information related to the injury
- Document case activities and action plans
- Respond to incoming phone calls and faxes on a timely basis to ensure statutory timeframes are met and excellent customer service is provided
- Work closely with Medical Directors and the treating providers to assess, implement, and evaluate medical treatment provided to the injured person
- Schedule independent medical examinations
- Address all aspects of medically managing the claim
- Candidate must have the ability to multitask in time sensitive situations
- Candidate must have strong organization, verbal and written communication skills and have the ability to work in a team environment
- May be required to perform field visits where necessary
Qualifications and Education
- Current New Jersey / New York RN or LPN license
- Organized, motivated, self-starter
- Excellent medical assessment skills
- Minimum of 2 years clinical experience
- Proficient in navigating through multiple system applications
- Prior utilization review experience from a NJ/NY Automobile, Workers Comp, or Managed Care company is a plus.
About the Company
The Plymouth Rock Company and its affiliated group of companies write and manage over $2 billion in personal and commercial auto and homeowner’s insurance throughout the Northeast and mid-Atlantic, where we have built an unparalleled reputation for service. We continuously invest in technology, our employees thrive in our empowering environment, and our customers are among the most loyal in the industry. The Plymouth Rock group of companies employs more than 1,900 people and is headquartered in Boston, Massachusetts. Plymouth Rock Assurance Corporation holds an A.M. Best rating of “A-/Excellent”.
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