Workers Comp Patient Care Coordinator - Dr. Hrubes
About The Position
This role provides comprehensive administrative and operational support to Dr. Melody Hrubes’ practice. The position serves as a liaison between Workers' Compensation claimants and HSS services, as well as with Workers' Compensation Insurance Companies and specialty providers. Key responsibilities include managing the full cycle of workers' compensation claims, ensuring compliance with regulations, obtaining authorizations for services, and coordinating medical care to ensure patient needs are met and quality outcomes are delivered. The role also involves educating providers and staff on proper procedures and compiling reports. The position requires strong organizational, communication, and problem-solving skills, with a proficiency in Microsoft Office and the Epic Medical Records System.
Requirements
- Experience with Epic Medical Records System required
- Strong computer skills required
- Excellent interpersonal communication to maintain positive and productive working relationships
- Experience working with insurance carriers, claims adjusters, and legal professionals
- Experience dealing with claim investigations, settlements, litigation, and denials
- Demonstrated knowledge of NYS Worker’s Compensation Law
- Demonstrated ability to successfully manage multiple tasks simultaneously demonstrating flexibility and creativity.
- Superior written and oral communication skills
- Exceptional customer service skills
- Ability to follow through with tasks to completion
- Strong organizational and problem-solving skills
- Ability to multitask in a fast-paced environment
- Ability to effectively and accurately follow directions or instructions
- Ability to work collaboratively as part of a team; offers to help coworkers when needed
- Detail-oriented
- Ability to escalate issues appropriately
- Consistently displays a positive attitude towards one’s work and work environment
- Knowledge of healthcare and health insurance, required
- Familiarity with medical terminology and general office protocol required.
- Ability to type 45-60 words per minute and exceptional organizational strengths is required.
- Must be proficient in Microsoft Word, Excel, and PowerPoint.
- High School Diploma or equivalent
- At least two years of related MD office/healthcare experience
- At least two (2) Worker's Compensation experience (State workers compensation experience required; State and Federal preferred)
Nice To Haves
- Associates Degree preferred
- Relevant certifications (e.g., Certified Workers' Compensation Professional - CWCP) are preferred
Responsibilities
- Serve as liaison between the entry point of a Workers' Compensation claimant and all pertinent HSS services involved.
- Serve as liaison with Workers' Compensation Insurance Companies and specialty providers to ensure a seamless transition of information, authorizations, and any other identified documents.
- Gather all documentation from visits and submit to claims' adjusters and nurse case managers as required.
- Verify accidents with claimants.
- Investigate and process workers' compensation claims.
- Create and manage the full cycle of workers' compensation claims, including intake, investigation, documentation, and resolution.
- Stay up to date on federal and state workers' compensation regulations to ensure compliance in all aspects of claims management and reporting.
- Obtain authorizations for services, document approvals within the Electronic Medical Record, and coordinate and schedule approved services.
- Provide case coordination and oversight to streamline and expedite the provision of medical services to maintain good relationships with insurance carriers and HSS.
- Facilitate all adjuster and nurse case management needs to ensure recurrent referrals.
- Ensure needs of patients are being met and that quality customer experiences and outcomes are being delivered.
- Provide education and support to providers and providers' staff to ensure proper pre-service, documentation, and authorizations processes are followed.
- Compile and distribute reports as requested.
- Establish and maintain case files, logs and indexes.
- Monitor claimants’ case histories, including any previous claims.
Benefits
- additional benefits consistent with the role
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
