Workers Compensation Specialist

Tennessee Orthopaedic Alliance•Knoxville, TN

42m

About The Position

Tennessee Orthopaedic Alliance is the largest orthopaedic surgery group in Tennessee. TOA concentrates on the diagnosis and treatment of disorders and injuries of the musculoskeletal system which allow our patients to live their best life. Ninety plus years later we are advancing the practice of orthopaedic surgery throughout the state. There are a number of reasons why TOA is an employer of choice; here are a few of them: Stability - TOA has been in Middle Tennessee since 1926 and has expanded to over 20+ locations across the state! Impact - TOA’s team members use our careers – whether in our clinics or our business office – to make a positive difference in the community by building relationships and helping patients live their best life. Work Environment - The TOA team focuses on fostering an excellent working environment; one of positivity, collaboration, job satisfaction, and engagement. Total Rewards - TOA offers a comprehensive suite of benefits, including Medical, Dental, Paid Time Off, and more. Our 401(k) plan provides a company match, safe harbor match and profit-sharing match to go along with your contributions. TOA is seeking a Workers' Compensation Specialist, a high-performing individual who will focus on serving those TOA patients who are utilizing Workers' Compensation benefits. This role provides coordination between patients, TOA, and Workers' Compensation carriers to ensure care is scheduled appropriately and free from complication. The Workers' Compensation Specialist reports directly to the site manager, but may have interaction with to the Director of Workers Compensation.

Requirements

A Bachelors Degree is preferred, and a high school diploma or equivalent is required.
At least one year medical office administration or clinical experience is preferred, with demonstrated success understanding some experience with Workers' Compensation or an orthopaedic office a plus
Exceptional customer service and patient focus. Our Workers' Compensation Specialists must make each encounter as positive as possible, realizing we are there to serve patients, their employers, and other stakeholders in the most professional manner
Multi-tasking and successfully operating in a fast-paced environment, with the demonstrated ability to handle a high volume of telephonic inquiries and documentation workflow with a high degree of accuracy
Knowledge of Insurance, particularly workers compensation and health insurance provisions is essential,
Previous experience including collecting co payment, deductibles, coinsurance, and balances
Knowledge of administrative and clerical procedures, including experience with computer systems. Experience with an EHR or NextGen is a plus
Focus on attention to detail, ensuring that all documentation is entered accurately and swiftly
The ability to multi-task and maintain flexibility – including flexibility in work schedules to adjust to necessary clinic hours
Collaboration, working closely with clinical colleagues and administrative team mates to develop a cohesive, high performing team
An energetic and enthusiastic pace at work, with the ability to swiftly and accurately manage the flow of patients through the clinic, without any diminishing focus on patient care Dependability, with a reliance on the capacity to be at work on-time, every day so our patients can receive the care they need in a timely manner

Nice To Haves

At least one year medical office administration or clinical experience is preferred, with demonstrated success understanding some experience with Workers' Compensation or an orthopaedic office a plus
Experience with an EHR or NextGen is a plus

Responsibilities

Field initial outreach from injured workers or their employers to facilitate services by TOA
Obtain authorization and pre-certification for services such as examinations, physical therapy, diagnostics and other ancillary services
Schedule workers’ compensation appointments, follow-up appointments, and coordinate the scheduling of ancillary services
Work closely with employers, insurance adjusters, attorneys, an physicians to communicate and collaborate on workers' compensation case issues
Manage the workflow of assigned workers' compensation cases, including telephone and email inquiries from employers, insurance carriers, and case managers, attorneys regarding injured worker
Obtain information and entering pertinent data into our computer systems – including the completion and timely distribution of necessary documentation to the proper party