Workers Compensation Triage Nurse

Job Title

Workers' Compensation Triage Nurse

Monday-Friday 8-5pm

Full-Time

We always strive to make your experience at Nebraska Orthopaedic Center a friendly, comfortable, and positive one. We want you to feel you received the same high-quality care we would offer a member of your own family. At NOC, we strive to be your healing destination.

The Clinical Triage Nurse plays a critical role in ensuring high-quality, efficient patient care by assessing patient needs via phone triage, providing appropriate clinical advice, and coordinating care across multiple departments and external facilities. This role supports clinic operations and contributes to the overall patient experience and outcomes.

• Act as the clinical point of contact for Workers' Compensation orthopedic patients and triage calls.
• Conduct initial patient assessments by phone to determine condition severity and appropriate level of care.
• Educate patients on the Workers’ Compensation process, clinic procedures, and care expectations.
• Coordinate scheduling for evaluations, follow-ups, imaging, therapy, and procedures/surgery.
• Track Workers’ Compensation cases from initial visit through discharge, PRN, or MMI.
• Prepare and manage Workers’ Compensation documentation, including work status reports and treatment plans.
• Monitor prior authorizations and precertifications for diagnostics, therapy, DME, and procedures.
• Communicate with adjusters, nurse case managers, employers, outside providers, rehab facilities, and surgery centers.
• Ensure providers receive all necessary claims and injury-related documentation prior to patient visits.
• Address patient questions regarding authorization status, scheduling, symptoms, and work restrictions.
• Advise patients on symptom management and preparation for testing or procedures per provider protocols.
• Maintain accurate and complete documentation of patient history, triage decisions, and communications.
• Monitor patient portal messages and ensure timely follow-up.
• Support return-to-work and modified duty planning.
• Ensure compliance with state WC regulations, payer requirements, and HIPAA standards.
• Collaborate with clinical, front desk, billing, and authorization teams to support efficient care coordination.
• Identify process improvement opportunities to enhance efficiency and patient outcomes.

• The ability to assess a wide range of symptoms quickly and determine the best course of action.
• Strong verbal skills to explain medical conditions and procedures clearly to patients, as well as collaborate with the healthcare team.
• Understanding medical terminology, common musculoskeletal injuries, treatments, and conditions is vital for accurate triage and patient education.
• Ability to multi-task, effectively managing time and prioritizing tasks.

• A valid RN, LPN, ATC or Medical Assistant license.
• Previous nursing experience in a clinical, urgent care or ER setting preferred.
• 1-2 years of experience in WC Claims or related procedures is preferred.

EOE

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Employee assistance program
• Flexible spending account
• Free parking
• Health insurance
• License reimbursement
• Life insurance
• Paid time off
• Tuition reimbursement
• Vision insurance