Worker's Comp & No Fault Coordinator

Spire Orthopedic Partners•Village of Great Neck, NY

8d•$22 - $27•Onsite

About The Position

Spire Orthopedic Partners is a growing national partnership of orthopedic practices that provides the support, capital and operational resources physicians need to grow thriving practices for the future. As a Management Services Organization (MSO), Spire provides the infrastructure for administrative operations that allows practices to operate at their highest level, so doctors can focus their efforts on what matters most – patient care. Headquartered in Stamford, Connecticut, Spire Orthopedic Partners is a growing partnership of orthopedic practices that provides the support, capital and operational resources physicians need to grow thriving practices in today’s evolving healthcare landscape. The Spire network spans the Northeast with more than 165 physicians, 1,800 employees, 285 other clinical providers and 40 locations in New York, Connecticut, Rhode Island and Massachusetts.

Requirements

High School Diploma or equivalent GED.
Updates the system to record the Workers Compensation Authorization related information.
Excellent oral, written, computer and customer service skills
Experience working in a medical office
Strong communication, problem-solving and analytical skills
Ability to work independently and in a team environment
Must have attention to detail with an eye for accuracy
Proficient in electronic medical records
Strong follow-up and organizing skills
2+ years prior with workers compensation/ no fault authorization experience preferred.
Working knowledge of medical terminology, abbreviations, and anatomy.
Knowledge of the New York Workers compensation Board website.
Workers compensation experience for New York and Connecticut 2+ years is required. Rhode Island and Massachusetts a plus.
Experience with filing claims electronically and on paper.
Strong attention to detail.
Self-directed and motivated to work efficiently.
Ability to work in a high-volume patient environment
Experience with Microsoft Excel and Word.

Responsibilities

Coordinate and collect necessary information from staff, patients, employers, adjusters and payers for claim adjudication.
Knowledge of workers’ compensation rules and laws.
Communicating directly with insurance carriers on Workers Compensation accounts to verify the cases are open and enter all documentation that includes attorney contacts, case, carrier, date of accident, date of injury and appropriate body part.
AR Follow up
Correspondence review
Payment posting discrepancies
Adheres to all HIPAA guidelines and regulation.
Validate WC insurance using the board website
Review and submit authorizations via WCB Board for applicable payers
Escalate Level 3 authorization submissions
Communicate denials with clinical and Ops Team
Communicate approvals with patient and scheduling vendors
Handle inbound questions regarding authorization and claim statuses.
Work closely with our authorization vendor to ensure timely and accurate authorization submissions.