Mambo Seafood Restaurants · 6 days ago
Worker’s Compensation Coordinator
Lawrenceville, GA
Full-time
Onsite
Entry Level
1+ years expSummit Spine and Joint Centers is on track to become the largest comprehensive spine and joint care provider in Georgia. They are seeking a WC Coordinator to assist patients with their coverage and navigate the workers' compensation process, while effectively communicating with various stakeholders.
Food & Beverages
Responsibilities
Appropriately document all communications with patients, including regarding all actions, authorization details and modifications
Work accurately, work well independently and with others, and able to maintain focus under pressure
Liaison with insurance providers, legal professionals, and other healthcare providers to facilitate the timely processing of claims, continuity of care for patient treatment, and effective communication between all parties involved
Schedule Peer-to-Peer meetings between external insurance companies and in-house providers to resolve potential insurance coverage denials
Coordinate & schedule medical appointments, evaluations, and treatments for injured patients as necessary
Coordinate with physicians in completing monthly attending physician statements and worker’s compensation forms after each patient’s appointment
Providing any necessary medical notes, referrals, forms, and itemized statements to insurance providers, claims adjusters, nurse case managers, and legal professionals
Complete and submit WC205 forms and out of state request for authorization forms to adjusters and legal professionals to obtain approval for ambulatory surgical center appointments for patients
Obtain approvals for treatment from worker’s compensation adjusters and nurse case managers prior to initial treatment appointment
Qualification
Required
Detail oriented with excellent phone call diction
Outstanding customer service skills
Ability to liaise with 3rd party attorneys and WC Insurance Adjusters
Problem-solving skills
Ability to multitask in a fast-paced practice
Ability to document all communications with patients accurately
Ability to work independently and with others
Ability to maintain focus under pressure
Ability to facilitate the timely processing of claims
Ability to coordinate and schedule medical appointments, evaluations, and treatments
Ability to complete and submit WC205 forms and out of state request for authorization forms
Ability to obtain approvals for treatment from worker's compensation adjusters and nurse case managers
Personable and detail oriented
Excellent verbal and written skills for proper documentation
Working knowledge of medical terminology and insurance plans
Preferred
Proficiency with EMR (EClinical Works)
1+ years' experience in a medical setting
Bilingual candidates encouraged
Company
Mambo Seafood Restaurants
Mambo Management is the parent company of Mambo Seafood Restaurants.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Nuno Lima
Chief Executive Officer
Tim Leong
CFO
Company data provided by crunchbase