Worker Compensation Specialist
Healthcare Outcomes Performance CompanyESSENTIAL FUNCTIONS
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Reviews Worker’s Compensation accounts and forms for accuracy and completeness.
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Answers questions and provides information pertaining to well-defined areas, which require interpretation of policy.
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Responsible for processing 102 forms and mailing copies to the Industrial Commission.
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Interacts with claims adjustors to verify patients work status and scheduled appointments.
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Communicates verbally and in writing regarding interpretation of local and out of state guidelines and policies.
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Maintains all records and reports.
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Responds to telephone calls from internal staff, patients, adjustors and case managers.
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Obtains authorizations for initial visits, surgeries and physical therapy.
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The job holder must demonstrate current competencies for job position
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High school diploma/GED or equivalent working knowledge preferred.
EXPERIENCE
- One-year medical billing or medical business office experience in physician office or hospital environment.
KNOWLEDGE
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Knowledge of billing and related functions and tasks.
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Knowledge of large physician group operation and clinic policies.
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Knowledge of Worker’s Compensation processes and requirements.
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Knowledge of payer specific requirements, state and federal regulations.
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Knowledge of authorization and verification processes.
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