Description:
Purpose
The Workers Compensation Coordinator role is responsible for serving as the primary point of contact for worker’s compensation (W/C) issues and assisting patients, nurse case managers, employers and insurance adjusters with questions on medical services provided, insurance claims, home health care, medical equipment, surgical care, etc.
Responsibilities
Duties and responsibilities include, but are not limited to:
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Scheduling appointments for W/C patients, obtaining approval (verifying benefits and coverage) from the employer/insurance company and documents information in Epic.
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Responsible for sending office notes, work status reports, therapy/radiology orders, operative reports and procedure reports to all W/C designated parties.
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Assist patients with obtaining necessary forms for claim approval for treatment, surgery and tests for the work related injury.
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Providing prompt communication to nurse case managers, employers and insurance adjusters ensuring that the information they require to approve additional services is received.
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Documenting all communication and maintains permanent record of all W/C correspondence.
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Identifying and correcting patient account and insurance errors to ensure responsible party is appropriately billed.
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Auditing work status reports prior to submission to ensure diagnosis and restrictions (if any) were completed accurately and thoroughly and correlate with physician’s notes.
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Addressing all inquiries received from patient, case manager, insurance company and employer regarding worker’s compensation accounts.
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Completing other comparable duties and assignments as directed by the Workers Compensation/Legal Manager and/or Supervisor.
Requirements:
Experience
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At least 2 years administrative experience
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Knowledge of medical terminology required.
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Previous experience with W/C insurance and billing procedures.
Qualifications
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High school graduate or equivalent required.
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Associates degree in business/communication field preferred.
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Must be available to work a flexible schedule to meet the demands of a changing scheduling environment and accommodate the needs of the practice.
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Possess good working knowledge of Microsoft Office and Windows-based computer applications. Able to interact with computers to enter data or process information.
Skills
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Must be a self-starter, highly organized with good time management skills.
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Able to multi-task and work in a fast-paced environment.
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Communicate effectively verbally and in writing to document/record information.
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Strong interpersonal skills, able to work well and communicate professionally with physicians, patients and staff in all levels in the organization. Able to develop constructive and cooperative working relationships with others and maintain them over time.
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Capable of filing materials correctly within an alphabetic or numeric system.
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Ability to understand and follow a variety of oral and written instruction.
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Ability to define problems, collect data, establish facts and draw valid conclusions.
Physical/Mental Demands
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Work may require hand dexterity for office machine operation, using calculator and/or computer keyboard.
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Physical demands may also include stooping, bending or reaching to files and supplies, wearing a headset, mobility to complete errands or deliveries, sitting for extended periods of time and viewing a computer monitor.
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Travel from site to site may be required.
Environmental/Working Conditions
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Work is performed in a clinic office environment and involves frequent contact with physicians, staff, patients, and NCM and Adjusters.
This description is intended to provide only basic guidelines for meeting job requirements. Duties and responsibilities, experience, qualifications, skills, supervisory relationship, physical/mental demands, and environmental/working conditions may change as needs evolve.