1 staff attorney jobs found

Berkshire Hathaway Homestate Companies, Workers Compensation Division, has an opening for a Utilization Review Specialist in Omaha to join its Medical Management team.  The individual ensures that medical treatment requests from providers are medically appropriate and reviewed in compliance with State laws and Company policies.    ESSENTIAL RESPONSIBILITIES Triages and manages intake coordination of requests for authorization and independent medical review requests.  Reviews authorization requests for approval in accordance with evidence-based medical treatment guidelines.  Researches claim files in relation to the requested medical treatment, interprets medical reports while utilizing critical thinking, and applies appropriate established guidelines to requested treatment.  Advocates for the injured worker and Claims department, ensuring proposed treatment requests are appropriate for the diagnosis.  Escalates treatment requests outside of authorization...