What are the responsibilities and job description for the OAG - Crime Victims Division | Nurse I | 25-0161 position at OFFICE OF THE ATTORNEY GENERAL?
GENERAL DESCRIPTION
The Crime Victim Services division of the Office of the Attorney General is seeking a Nurse whose work will involve analytical work for the division. Work involves independently gathering information and verifying the extent of the victims’ or survivors physical and/or emotional injuries; gathering information from medical providers to determine disabilities and expected future financial losses for the purpose of determining eligibility for reimbursement for claims filed under the Crime Victims’ Compensation Act. Work also involves utilization review, pre-authorization of treatment and consultation to other staff for the most complex medical claim issues.
The OAG is a dynamic state agency with over 4,000 employees throughout the State of Texas. As the State’s law firm, the OAG provides exemplary legal representation in diverse areas of law. OAG employees enjoy excellent benefits (https://ers.texas.gov/Benefits-at-a-Glance) along with tremendous opportunities to do important work at a large, dynamic state agency making a positive difference in the lives of Texans.
ESSENTIAL POSITION FUNCTIONS
- Reviews evidence of injury and medical treatment for the purpose of determining if the injury and medical treatment is a direct result of the crime, and that the costs of medical treatment are actual, reasonable and necessary according to the guidelines established by the Texas Workers’
- Compensation Medical Fee Guidelines
- Reviews and analyzes evidence of injury to preauthorize treatment and/or services and makes recommendations to team leaders and management
- Plans and conducts interviews of physicians and other allied health professionals to clarify complex medical issues concerning the injury or medical treatment
- Examines medical bills to determine that the treatment is related to the crime and that the treatment expenses are actual, reasonable and necessary in accordance with the guidelines established by the Texas Workers’ Compensation Medical Fee Guidelines
- Drafts correspondence to crime victims, claimants, providers of medical services and victim service staff
- Gathers and documents collateral resource information that may be available to the victim/claimant
- Coordinates with community resources, attorneys, third party payers, and others related to the claim to manage the claim in the most advantageous way possible for the victim
- Provides advice and counsel to case managers on complex medical matters in a claim
- Performs related work as assigned
- Maintains relevant knowledge necessary to perform essential job functions
- Attends work regularly in compliance with agreed-upon work schedule
- Ensures security and confidentiality of sensitive and/or protected information
- Complies with all agency policies and procedures, including those pertaining to ethics and integrity
MINIMUM QUALIFICATIONS
- Licensed as a Registered Nurse in the State of Texas
- Two years full-time nursing experience
- Knowledge of diagnosis codes and procedures
- Knowledge of Texas Workers’ Compensation Medical Fee guidelines
- Skill in handling multiple tasks, prioritizing, and meeting deadlines
- Skill in effective oral and written communication
- Skill in exercising sound judgment and effective decision making
- Ability to receive and respond positively to constructive feedback
- Ability to work cooperatively with others in a professional office environment
- Ability to provide excellent customer service
- Ability to arrange for personal transportation for business-related travel
- Ability to work more than 40 hours as needed and in compliance with the FLSA
- Ability to lift and relocate 30 lbs.
- Ability to travel (including overnight travel) up to 5%
PREFERRED QUALIFICATIONS
- Two years full-time claim processing experience
- Experience in a victim services or social services agency
- Knowledge of the issues of victimization and the victim services delivery system in the State of Texas
- Knowledge of the principles and practices of utilization review (concurrent, prospective, or retrospective)
TO APPLY
To apply for a job with the OAG, electronic applications can be submitted through CAPPS Recruit. A State of Texas application must be completed to be considered, and paper applications are not accepted. Your application for this position may subject you to a criminal background check pursuant to the Texas Government Code. Military Crosswalk information can be accessed at
https://hr.sao.texas.gov/Compensation/MilitaryCrosswalk/MOSC_MedicalandHealth.pdf
THE OAG IS AN EQUAL OPPORTUNITY EMPLOYER
