WC Field Case Manager
- 0Jun 5, '13 by QTNurseBSNHello,
I am inquiring if there are any Workman Comp Field Case Managers out there? If so, what is your day typically like? Is the job stressful? Is the salary comparable to working in the hospital or is it more? I hear some companies offer a salary in addition to billable time and milage reimbursement.
I am currently a salaried Nurse Case Manager (not in WC) and I do not bill for any of my services or travel for mileage reimbursement. I have an interview for a Workmans Comp Field Case Manager Position and wanted to hear from others in this forum about their experience.
- 2Jun 6, '13 by GrnTea, BSN, MSN, RNFirst, it's called "workers' comp," since women work and get injured on the job too.
I did work comp for many years. There are two different ways to do this, telephonic and field case management.
In telephonic case management, you'll have a case load of people you will never see, but you will know all about them. You will interact with them, their employers, their treating physicians and therapists, and get them what they need to heal up and return to work. You'll have quotas for how many calls to make, get graded on how many you get to return to work, and if they let you work out of a home office they'll give you a laptop and can monitor it remotely to see your usage.
Field case management is the same, except you will spend a lot of time traveling about to meet patients, coordinate and attend MD appointments, so you can observe the exams and explain all over again to the patients what the physician said
In both you will be reporting to the insurance adjusters, the folks who write the checks. They have responsibilities to their bosses to move cases along within statutory time frames, deal with any legal issues, and in some cases, give approval for treatment or surgery. You will need to know what the laws are for comp in your state, and what you can and cannot do.You'll write a monthly report on every case to say what's been going on, what you did in the past month to meet the plan you made last month, and what your plan is for the next month. You will account for all of your activities based on the billable hours thing.
I got paid bonuses for more billable hours, and for more return-to-work cases. There's always the "You don't care about me, you work for the insurance company, you just want to save money." That's when you explain that everybody saves money when he gets better, because he gets more money working than he does in his comp check, his employer's insurance premium doesn't go up when his medical costs don't rise, and of course the insurance company saves money if there are fewer medical bills. Then I say, "The only one who doesn't make more money if you get back to work is the physician."
Your biggest challenge is convincing people who are terrified that they can not work again that their pain isn't dangerous (if it isn't) and that they will be OK. If you hook up with the CMSA you'll meet lots of your peers who can give you invaluable help and advice, tell you who the good docs are to make referrals to and which ones to stay away from, and how to deal with the lawyers. It's a lot of fun, but it's different.