Founded in 1991, Injury Management Organization, Inc. (IMO) is a managed care company serving public and private employers, nonsubscribers, insurance carriers and third party administrators. Taking quality and client satisfaction seriously, our focus is driven by provider relationships, employee engagement and measurable outcomes.
We are a trusted managed care partner for both private and public enterprise with vast experience in quality case management and positive injured employee outcomes. For over three decades our goal has been to provide industry leading customer service to our industry partners and their injured employees - a goal that has allowed IMO to grow from Texas into multiple other states including Arkansas, Florida, Illinois, Colorado, Louisiana, Oklahoma, Arizona, and New Mexico.
This is a full-time position in Plano, TX - Hybrid role after completion of 90-day training, full benefits, PTO, paid holidays, matching 401(k), $50,000 life.
SUMMARY
Must be an LVN - Process incoming requests from clients and from health care provider bill submissions. Collect clinical data to support the request in order to forward the file for PR/RME/DDE/RUR/LMA. The nurse must also be able to perform and process clinical data reviews for preauthorization requests for injured employees using standard evidenced-based practice guidelines. Must be able to compile, process and maintain medical records of injured employees in a manner consistent with medical, administrative, ethical, legal and regulatory requirements of the health care system with maintaining compliance through instruction and pre-established guidelines to perform the functions of the job. Familiar with standard concepts, practices and procedures within the medical field, Division of Workers Compensation and the Texas Law regarding workers compensation. Assist with Preauthorization tasks and projects as requested.
-
Coordinate and process in excess of 20 ancillary services requests weekly
-
Scrub and organize in excess of 20 files weekly of medical records ranging from 1-1,000 pages
-
Interpret and evaluate diagnostic tests to identify and assess patient's condition
-
Record each case in the system utilizing clinical summary format with a decision on whether to pre-approve the request as medically necessary or consult a physician advisor for determination
The successful candidate will be an LVN, possess an advanced skill level in computer literacy to enter, access or retrieve data with high level of accuracy and type 40+WPM, and be familiar with medical terminology, ICD-10 and CPT coding. Possess the ability to conduct face-to-face discussions with individuals and team.
EDUCATION and/or EXPERIENCE
Active LVN or LPN license in the State of Texas-
Requires a 1, 2 or 4-year degree
-
Familiar with Texas Law and Division of Workers' Compensation preferred
-
Medical office/clinical experience of 2-3 years
-
Medical terminology, ICD-10 and CPT coding required
-
Bilingual in Spanish a plus
Salary range $24-$26/hour / fulltime with benefits, PTO, paid holidays, matching 401(k)