Workers Compensation Specialist

Job Title: Professional Reimbursement Specialist - Workers Compensation

Key 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.?

Skills and Qualifications:

• 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. 

We offer a competitive salary and benefits package, along with opportunities for professional growth and development. If you are a motivated individual with a passion for reimbursement processes, we encourage you to apply.

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