Tri-City Medical Center

Workers Compensation Coordinator

Posted Date 7 days ago(2/14/2018 7:21 PM)
ID
2018-6546
FTE Status
Full-Time 1.0
Shift
Day
Cost Center/Dept
7095 - OSNC
Work Schedule
8

Overview

Position Summary:

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

  • Responsible to maintain a safe and clean environment, including department/unit based safety and infection control requirements.

 

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.

Practice Requirements

  • 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

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