Worker’s Compensation Coordinator

• Employee Type FT Non-Exempt

Description

Company Overview:

Summit Spine and Joint Centers (SSJC) is on track to become the largest comprehensive spine and joint care provider in the state of Georgia while providing clinical, surgical, and imaging services to our patients.

Job Description Summary:

As a WC Coordinator, an employee must be detail oriented with excellent phone call diction, and outstanding customer service skills, so they may help patients understand their current coverage, status, and financial obligations related to treatment. A successful employee must also be able to liaise with 3rd party attorneys and WC Insurance Adjusters to navigate the WC process. The employee must be able to problem-solve and multitask as we are a fast-paced practice.

This job is a full-time, benefited position at Summit Spine & Joint Centers that reports to the Administrative Manager. This position's primary location will be at the SSJC Administrative Building in Lawrenceville, GA.

Responsibilities:

• Appropriately document all communications with patients, including regarding all actions, authorization details and modifications.
• Work accurately, work well independently and with others, and able to maintain focus under pressure.
• Liaison with insurance providers, legal professionals, and other healthcare providers to facilitate the timely processing of claims, continuity of care for patient treatment, and effective communication between all parties involved.
• Schedule Peer-to-Peer meetings between external insurance companies and in-house providers to resolve potential insurance coverage denials.
• Coordinate & schedule medical appointments, evaluations, and treatments for injured patients as necessary.
• Coordinate with physicians in completing monthly attending physician statements and workers' compensation forms after each patient's appointment.
• Providing any necessary medical notes, referrals, forms, and itemized statements to insurance providers, claims adjusters, nurse case managers, and legal professionals.
• Complete and submit WC205 forms and out of state request for authorization forms to adjusters and legal professionals to obtain approval for ambulatory surgical center appointments for patients.
• Obtain approvals for treatment from workers' compensation adjusters and nurse case managers prior to initial treatment appointment.

Skills And Abilities:

• Must be personable and detail oriented as a representative of the practice while callers rely on accurate information.
• Excellent verbal and written skills for proper documentation of encounters.
• Bilingual candidates are encouraged to support our diverse patient base.

Education And Experience:

• Working knowledge of medical terminology and insurance plans required.
• Proficiency with EMR (EClinical Works), 1+ years' experience preferred.
• 1+ years of experience in a medical setting preferred.

The employee must communicate professionally, respectfully, and effectively with patients, visitors, clinicians, coworkers, and vendors, including in busy, demanding, or stressful circumstances. The employee must maintain professional composure and consistently perform assigned duties throughout the scheduled work period; manage routine workplace stressors and feedback without disrupting patient care, patient-facing operations, or coworkers' work; and use established de-escalation and escalation procedures when appropriate. The employee must exercise sound judgment; maintain appropriate workplace boundaries; receive and respond to routine feedback and direction; protect confidential patient and business information; and address patient or workplace concerns through established supervisory and safety procedures. These functions are essential to the position.