Workers Compensation Representative

ORTHOCINCY•Edgewood, KY

1d•Onsite

About The Position

Responsible for all aspects of worker’s compensation. This includes answering and returning calls, intake of injured worker information, verifying and pre-authorizing claims, and managing injured worker claims. The role also involves addressing work status report questions, preparing reports, and handling precertification and tracking of tests, surgeries, and referrals. Additionally, the representative will track and complete disability forms, inform employers and facilities about the worker's compensation program, review accounts receivables, and ensure compliance with HIPAA guidelines. A passion for customer service, and the ability to establish and maintain effective working relationships are essential. Performs other duties as necessary.

Requirements

High School Diploma
One to three years experience in the procedures of worker’s compensation
One to three years of medical billing or coding experience (preferably in Orthopaedics)
Knowledge of HIPAA regulations
Knowledge of worker’s compensation policies and regulations
Basic to intermediate knowledge and familiarity with coding procedures and diagnosis
Knowledge of practice management and electronic health records systems
Accuracy in data entry
Detail oriented
Excellent adaptability skills
Ability to work under pressure with time constraints
Ability to work effectively and deal courteously with patients, staff, and others
Ability to enter accurately data and examine insurance documents
Can work independently with minimal or no supervision

Nice To Haves

Preferably in Orthopaedics for medical billing or coding experience

Responsibilities

Answer and return incoming worker’s compensation calls in a timely, courteous manner.
Intake all injured worker’s information including patient demographics.
Verify, re-verify and pre-authorize worker’s compensation claims with the employer, nurse case manager, and/or insurance carrier.
Responsible for case management of the injured worker’s claim.
Address all issues regarding work status report questions and concerns to the provider’s specifications and requirements.
Responsible for preparing the work status reports for upcoming appointments.
Responsible for precertification and tracking of pre-certifications for all ordered tests, surgeries, and referrals of worker’s compensation patients.
Responsible for tracking, completing, and/or faxing disability forms for Worker’s Compensation patients.
Assist with informing employers, nurse case managers, and Occupational Medical Facilities about our worker’s compensation program and policies to ensure them that COC should be their orthopaedic choice.
Review workers compensation accounts receivables and respond to billing companies request for information.
Compliance with HIPAA guidelines.
Demonstrated passion for excellence with respect to treating and caring for customers in-person and over the phone.
Establish and maintain effective working relationships with patients, providers, co-workers, and outside referrals.
Performs other duties that may be necessary or in the best interest of the practice.