The Worker’s Compensation Coordinator works with Worker’s Compensation patients with scheduling new and existing appointments, completing registration in the practice management system, submitting for authorizations, and acts as a liaison for patients between adjusters, employers and physician teams. The Worker’s Compensation Coordinator will work with the practice patients, clinical teams and business office on accurately preparing the patient for their physician, MRI or Physical Therapy visit. This person takes incoming calls, enters basic demographics, including email, social, insurance and financial data into the Practice Management System. The Worker’s Compensation Coordinator will ensure that the patient has access to the patient portal, sends all forms and receives completed forms prior to the patient visit. They will ensure that patient satisfaction goals are met or exceeded.
Duties and Responsibilities:
Prepares medical charts and records for patient visits
Reviews specific protocols requested by client and advise specialty physician accordingly
Obtain authorizations from clients and insurance carrier for orthopedic treatment as prescribed by physicians. Report denials or delays to operations manager
Obtain authorizations for patient referrals to specialists, diagnostic testing and surgeries.
Advise physician in authorization request is denied
Maintain records of all referrals
Makes appointments for patients with specialists
Contacts patients who miss an appointment and/or report missed appointment to employer
Processes and mails or faxes reports to employers and insurance carriers
Mails or faxes status update reports
Tracks receipt of transcription reports. Reviews reports and files in orthopedic chart. Distributes copy of report to referring physician who will initial and return the report. Files report in patient’s medical chart. Mails reports to employers and insurance carriers
Files final copy of authorized referrals in patient file for physician review
Utilizes formal channels of communications to report concerns, personal requests and patient issues
Respects patient’s right to privacy and confidentiality
Maintains an orderly and professional working atmosphere
Reports to work properly dressed, according to the approved dress code
Adheres to guidelines concerning working hours and break periods
Understands and follows department’s organizational policies and procedures
Assists billing office with claims processing
Performs related work as requested
Safety and Infection Control Responsibilities
ESSENTIAL ORGANIZATIONAL BEHAVIORS
Demonstrates behaviors that are consistent with the Medical Center’s Mission and Values and those that reflect the “Seven Standards of Service Excellence”.
Performs job responsibilities in an ethical, compliant manner consistent with the Medical Center’s values, policies, procedures and code of conduct.
Works well with team members toward a common purpose. Reinforces the efforts and goals of the work group. Supports the team’s decisions, regardless of individual viewpoint.
Demonstrates flexibility in schedules and assignments in order to meet the needs of the Work Unit/Department.
Utilizes, maintains, and allocates equipment and supplies in a cost effective and efficient manner. Improves productivity through proper time management
Seeks feedback from customers and team members in order to identify and improve processes and outcomes.
Ensures that patient confidentiality is always protected, both audible and visible.
HIPAA Notice of Privacy Practices is on display and given to all new patients and then every three years
Ensure compliance with all medical practice regulations, such as, but not limited to HIPAA and OSHA
Qualifications: ESSENTIAL COMPETENCIES, KNOWLEDGE & EXPERIENCE
High School Diploma (Required), Bachelor’s Degree (Preferred)
Minimum of 1 year of experience in health care
Minimum of 2 years of billing and claims experience (Required)
Worker’s Compensation authorization and claims processing experience (Preferred)
Strong background in customer service
Competencies in the areas of leadership, teamwork and cooperation
Strong ethics and a high degree of personal and professional integrity
An effective communicator at all levels in the organization, with strong oral, written and persuasive skills