Workers' Comp Authorization Coordinator

About the role

The Workers’ Compensation Authorization Coordinator is responsible for obtaining pre-authorization for all diagnostics testing and surgical requests.

Responsibilities

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

Requirements

• High School education or equivalent required.
• 2-3 years relevant work experience in a medical office setting or related workers' compensation experience required.
• 1+ year obtaining prior authorizations required; experience supporting an orthopedic office preferred.
• Must be self-directed and able to work with minimal supervision and direction.
• Skills in oral and written communication.
• Knowledge of computer applications for Excel spreadsheets and word processing.
• Must be able to travel to all sites if/when necessary.