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UTILIZATION REVIEW SPECIALIST ***Medical Technicians, Allied Health Professionals, and LPNS are Encouraged to Apply***

Berkshire Hathaway Homestate Companies Omaha, NE
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Job Description

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NOTE: BHHC does not conduct interviews via social media (e.g. Google hangout, LinkedIn, etc.). Please be aware that any such contact is fraudulent and we advise that you not provide any personal information.

WHO WE ARE:

As a member of the Berkshire Hathaway group of insurance companies, we offer outstanding opportunities for professionals interested in working with a successful company. We offer unparalleled financial strength, stability and “large company” benefits, in addition to an exciting, friendly, “small company” atmosphere.

POSITION DESCRIPTION:

We are currently searching for experienced medical technicians from all disciplines and Allied Health professionals, and/or LPN's that are looking for an exciting, new opportunity as a Utilization Review Specialist in our Omaha, Nebraska office. The Utilization Review Specialist ensures all aspects of an injured worker’s treatment is effective, efficient, and in accordance with applicable legal requirements. 

ESSENTIAL RESPONSIBILITIES:

  • Triage and manage intake coordination of medical treatment authorization requests.
  • Review workers compensation medical treatment requests to ensure accordance with evidence-based medical treatment guidelines, which are generally recognized by the national medical community and are scientifically based. 
  • Research claim file in relation to the requested medical treatment while interpreting medical reports/claims summaries and applies appropriate established guidelines to requested treatment. Refers treatment requests outside of authorization authority for UR Nurse review. 
  • Advocate for the injured worker and claims department, ensuring proposed treatment requests are appropriate for the diagnosis. 
  • Routinely contacts providers to clarify treatment requests, examination findings, as well as obtain additional medical information as needed. 
  • Maintain patient confidentiality in discussions of treatment, disease process and conditions.
  • Maintains clear, concise, and accurate documentation of requested medical treatments to include clinical findings, treatment guidelines, and determination. 
  • Provide appropriate notices to providers, injured workers, claims staff, and attorneys. 
  • Proactively communicate any problems or issues that may adversely impact a client or the company directly to the supervisor.
  • Ensure work is performed in accordance with Company standards, training, and supervisory direction to ensure compliance with corporate and regulatory standards. 
  • Provide general office or administrative support throughout the department.
  • Foster a positive and close working relationship with other Company staff, including the claims staff, medical bill review, nurse case management, special investigations, legal, liens, the call center, and client services.    

QUALIFICATIONS:

  • Education and Experience: Licensed Practical Nurse (LPN) or other medical technician experience; Associate’s degree from an accredited college or technical school in the medical field, or at least six months of relevant experience and training; or an equivalent combination of education and experience. 
  • Language Ability: Able to read, analyze, and interpret evidence based guideline, statues, regulations, medical reports, medical coding, medical bills, and legal documents. Able to respond to technical inquiries or complaints from Company employees, and external sources.
  • Math Ability: Able to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. 
  • Reasoning Ability: Able to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Able to deal with problems involving several concrete variables in standardized situations.
  • Technical Skills: Knowledge of current recognized evidence based medicine guidelines, office operations, workflow analysis, and current technologies in telecommunications, data entry, and file management. 
  • Computer Skills: Knowledge of Microsoft Office software. Able to perform independent internet medical research. Able to quickly master proprietary and vended software applications.

COMPREHENSIVE BENEFITS PACKAGE:

  • Health and wellness – low premiums for medical, dental and vision coverage; also FSA, EAP, and wellness benefits
  • Company paid Life, Disability and AD&D benefits
  • Employee Retirement Savings Plan 401(d) with employer match up to 5% of compensation
  • Generous Paid Time Off and Holidays
  • Education Assistance Reimbursement
  • Leadership Programs
  • Recognition and Rewards Programs
  • Employee Referral Program
  • Company Store
  • Discounts across Berkshire Hathaway Inc. companies such as GEICO, Benjamin Moore, etc.

ABOUT US:

The Berkshire Hathaway Homestate Companies (BHHC) is a group of six insurance companies that are part of the Berkshire Hathaway Insurance Group. Our Workers Compensation Division provides premier workers compensation insurance coverage to employers across the country, with offices in San Francisco, San Diego, Pasadena, Omaha, St. Louis, Atlanta, and Dallas.

As a member of the Berkshire Hathaway Insurance Group, BHHC has earned an enviable record of success in the insurance industry that is supported by an A++ A.M. Best rating for the last 10 consecutive years. Our corporate size enables our organization to react swiftly and effectively to opportunities in the insurance marketplace. At the same time, our financial strength provides our agents and insureds security and makes us one of the best brands in the marketplace.

We value each individual and recognize that attracting and retaining high quality talent is essential to the success of our company. Our structure minimizes bureaucracy and creates an environment that encourages our employees to see the direct effects of their hard work throughout the company. Each division provides hands on training and maintains a small company feel, creating an atmosphere in which team players thrive.

Within the last few years BHHC Workers Compensation has seen significant growth, and we’re continuing to grow as we build one of the largest Workers Compensation companies in the country – join us!

This organization participates in E-Verify. For more information on E-Verify, please contact DHS: 888.897.7781 www.dhs.gov/E-Verify.

We will consider for employment qualified applicants with criminal histories as required by local ordinance. Additionally, no applicant will be denied employment solely on the grounds of conviction of a criminal offense except to the extent necessary to obtain a necessary license or to comply with The Violent Crime Control and Law Enforcement Act of l994, which prohibits the employment by an insurance company of persons convicted of certain crimes, unless a waiver is obtained.

Job Details

Date Posted July 13, 2018
Date Closes August 12, 2018
Located In Omaha, NE
Job Type Full-time Employee
Experience Level Entry Level (0-2 yrs. experience)
SOC Category 29-2061.00 Licensed Practical and Licensed Vocational Nurses
Zipcode 68102

This job offers the following benefits

  • 401(k) Retirement Savings Plan
  • Flexible Spending Accounts
  • Accidental Death and Dismemberment
  • Life Insurance
  • Long-Term Disability
  • Short-Term Disability
  • Vision
  • Voluntary Life Insurance
  • Employee Referral Program
  • Paid Holidays
  • Paid Vacations
  • Tuition Reimbursement
  • Wellness Program

This job requires the following skills

  • Nursing
  • Microsoft Office

Course(s) relevant to the skills listed for this position

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  • 401(k) Retirement Savings Plan
  • Flexible Spending Accounts
  • Accidental Death and Dismemberment
  • Life Insurance
  • Long-Term Disability
  • And More ...
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