Worker Compensation Specialist
Worker Compensation Specialist
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Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
ESSENTIAL FUNCTIONS INCLUDE BUT ARE NOT LIMITED TO:
Reviews workers compensation accounts and forms for accuracy and completeness.
Takes inbound calls from patients and insurance to set up patient charts schedule appointments.
Answers questions and provides information pertaining to welldefined areas which require interpretation of the policy.
Responsible for sending documentation and orders for each patient visit to the correct carrier.
Interacts with claims adjustors to verify patients work status and scheduled appointments.
Communicates verbally and in writing regarding the interpretation of local and outofstate guidelines and policies.
Maintains all records and reports.
Responds to telephone calls from internal staff patients adjusters and case managers.
Obtains authorizations for initial visits surgeries and physical therapy.
EDUCATION
High school diploma/GED or equivalent working knowledge preferred.
EXPERIENCE
Oneyear medical billing or medical business office experience in a physician office or hospital environment; OR
Workers Compensation experience is preferred.
REQUIREMENTS
Excellent verbal and written communication skills.
Experience working with Microsoft applications including Word. Excel and Outlook.
Ability to work productively in a fastpaced environment.
Ability to learn and retain company policies state and federal policies and workflow processes.
KNOWLEDGE
Knowledge of workers compensation and/or healthcare insurance
Knowledge of billing and related functions and tasks.
Knowledge of workers compensation processes and requirements.
Knowledge of payerspecific requirements state and federal regulations.
Knowledge of physician group operation and clinic policies.
Knowledge of authorization and verification processes.
SKILLS
Skill in the billing authorization process.
Skill in obtaining necessary approvals for workers compensation to reduce denials.
skill in the collection process for workers compensation.
Skill in Microsoft applications specifically Excel and Access.
ABILITIES
Ability to proficiently use arithmetic calculations in data collection and interpretation.
Ability to use interpersonal skills to establish/maintain cooperative relationships with patients families physicians
management and other staff.
Ability to communicate openly and honestly with management and staff.
PHYSICAL/MENTAL DEMANDS
This can occasionally be a highstress work area requiring the ability to make quick decisions while being organized and
prioritizing appropriately.
Requires sitting and standing associated with a normal office environment.
Some bending and stretching are required.
Manual dexterity using a calculator and computer keyboard.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
