Workers' Comp Authorization Coordinator

University Orthopedics • Mansfield, MA

7d • $21 - $26

About The Position

The Workers’ Compensation Authorization Coordinator obtains pre-authorization for diagnostic testing and surgical requests. The role supports patients by conducting phone triage, documenting questions, coordinating with medical providers to ensure thorough documentation, returning calls promptly, and verifying patient demographics and insurance information. The coordinator works with case managers, adjusters, employers, vendors, and Utilization Review, and applies workers’ compensation jurisdiction laws and regulations for Massachusetts and Rhode Island. Additional duties may be assigned by the Manager to meet department needs.

Requirements

• High school education or equivalent.
• 2–3 years of relevant work experience in a medical office setting or related workers’ compensation experience.
• At least 1 year of experience obtaining prior authorizations.
• Ability to work independently with minimal supervision and direction.
• Oral and written communication skills.
• Knowledge of computer applications, including Excel spreadsheets and word processing.
• Ability to travel to all sites if or when necessary.

Nice To Haves

• Experience supporting an orthopedic office.

Responsibilities

• Develop and maintain positive working relationships with case managers, adjusters, employers, and vendors.
• Obtain pre-authorization for diagnostic testing and surgical requests.
• Understand the utilization review process and work with Utilization Review.
• Conduct phone triage according to the scenario, document patient questions, consult medical providers for appropriate and thorough documentation, return patient calls in a timely manner, and verify patient demographics and insurance information.
• Understand and apply workers’ compensation jurisdiction laws and regulations for Massachusetts and Rhode Island.
• Perform additional duties as assigned by the Manager to meet department needs.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED