TSAOG Orthopaedics & Spine ยท 1 hour ago
Workers Compensation Specialist
TSAOG Orthopaedics & Spine is seeking a Professional Reimbursement Specialist - Workers Compensation. The role involves managing workers compensation communications and ensuring effective processing of patient cases and treatment orders.
Health CareMedical
Responsibilities
Manage workers compensation incoming calls, faxes, emails and referrals
Communicate effectively with adjusters, nurse case managers, referral sources, and physicians by obtaining or providing requested workers comp information on new or existing patients
Assists other departments and physician teams by providing or verifying workers comp information when needed?
Responding to and documenting patient cases to ensure proper processing and scheduling
Submit treatment orders to utilization review companies for approval and follow up to ensure complete authorization process
Schedule patient appointments and workers comp appointed exams?
Maintain knowledge and education to be effective and productive on prior authorization requirements
Work with individual department co-workers on special projects as requested by supervisor
Follow the requests and directions of department Lead, Manager, Director, and physicians
May be required to assist other areas in referrals/authorizations department when staffing is needed
Participate in monthly and quarterly meetings within respective department and team to discuss policies, protocols, and best-practices
Qualification
Required
Must have a High School Diploma or equivalent
Required knowledge of self-insured and network Workers Compensation programs, rules and regulations
Proficient computer skills
Exceptional customer service skills
Proficient and accurate data entry skills
Proficient with Microsoft programs (Excel, Word, etc.)
Ability to communicate effectively
Excellent research, follow-through and documentation are required
Prolonged sitting
Repetitive motion (data entry), and phone contact
Ability to multi-task, prioritize work and make sound judgements
Other duties as assigned as necessary and may vary at times, as needed, by your immediate supervisor or as directed by the company
Benefits
Competitive salary
Benefits package
Opportunities for professional growth and development