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Based in Atlanta, Georgia, Crawford & Company (www.crawfordandcompany.com) is the world's largest independent provider of claims management solutions to the risk management and insurance industry as well as self-insured entities, with a global network of more than 700 locations in 63 countries. The Crawford System of Claims SolutionsSM offers comprehensive, integrated claims services, business process outsourcing and consulting services for major product lines including property and casualty claims management, workers’ compensation claims and medical management, and legal settlement administration. The Company’s shares are traded on the NYSE under the symbols CRDA and CRDB.

Position Summary:
Reviews medical information to determine if requested treatment is medically necessary and appropriate to support the resolution of the claim.

Responsibilities:
Analyze medical information and applies established criterion to facilitate the utilization review process.
Research, review and prepare medical information to present and collaborate objectively with Broadspire Peer Physicians in order to facilitate case resolution.
Plan and organizes individual caseload to meet URAC and Jurisdictional regulatory
Utilize appropriate desktop resources to perform the utilization review process.
Collaborate and communicate effectively to promote the integration of all Broadspire Departments and products through interdepartmental referrals and communications.
Document pertinent information in internal and external communications to support Utilization Management services, and case resolution.
Perform other duties as required.

Education:
Valid Florida RN licensure required 

Knowledge and Skills:
Ability to work in an unstructured environment with staff located remotely throughout the country.
Must have strong written and verbal communication skills, as well as the ability to work well within a team environment.
Must have strong organizational skills.
Working knowledge of personal computers with the ability to use standard word processing software applications.

Experience:
Minimum of three (3) years diverse clinical experience or prior experience in managed care.

In addition to a competitive salary, Crawford offers you:
Career advancement potential locally, nationally and internationally. Crawford & Company has more than 700 locations in 63 countries;
On-going training opportunities through every stage of your career;
Strong benefits package including matching 401k; health, dental, and life insurance; employee stock purchase plans; tuition reimbursement and so much more.
 
Crawford & Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V

How to apply: DO NOT use the Apply Online button. Please copy and paste the following link into your browser address bar:
http://broadspire.contacthr.com/16608939

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Published on Jul 22, 2010
Viewed: 208 times