Workers' Comp Coordinator - Full-Time - AVALA Hospital - RH422

Essential Duties and Responsibilities

• Responsible for oversight of WC appointment types within provider’s schedules to ensure flow of patients is correct and matches the patient’s needs, etc.
• Provides patients, nurse case manager and adjusters with pre-registration instructions and directions to clinic locations.
• Efficiently and accurately gather and input patient demographic and payer and other necessary appointment information to ensure appointment is correct and can be billed correctly
• Obtains medical records and documents pertaining to the injury and treatment prior to appointments to ensure continuity of care and support the clinic work-flow
• Obtain the prior authorizations for ancillary services ordered by the provider (MRI, CT, Physical Therapy, Outside Referrals, PRP injections, Joint Medications, etc.).
• Work with the nurse case manager and adjuster to obtain the prior authorization and schedule the procedure(s) in a timely manner.
• Schedules patient appointments in the clinic once injections, tests and joint medication authorization is approved.
• Document all steps in the prior authorization process in the computer for all employees to have access to the information.
• Manage calendars/schedules to ensure tasks stay on track and all deadlines are met
• Handle confidential information and deal with professionals inside and outside the company with a high level of integrity and discretion
• Aid in communications, administrative tasks and scheduling related to each patient’s case
• Act as a liaison with claims adjusters, attorneys and patients to ensure all medical plans and obligations are met to their satisfaction
• Manage documentation and correspondence in strict confidence
• Responsible for oversight of case records, requesting documentation and case workflow
• Accurately document all communication and patient accounts of all actions taken in the EHR
• Maintain quality service by following organization standards.

Core Competencies

• Action Orientation
• Communications
• Creativity/Innovation
• Critical Judgment
• Customer Orientation
• Interpersonal Skills
• Leadership
• Teamwork

Professional Requirements

• Excellent organizational skills
• Strong communications skills
• Strong customer service experience
• Excellent time management skills and ability to multi-task and prioritize work
• Attention to detail and problem-solving skills

Regulatory Requirements

• High school diploma, GED, or equivalent
• Proven admin or assistant experience
• Previous medical software experience
• Workers comp experience required, preferred
• Additional degrees, business training experience and/or certifications may be combined to meet minimum qualifications
• Must have computer skills and dexterity required for data entry and retrieval of patient information.
• Effective verbal and written communication skills and the ability to present information clearly and professionally to varying levels of individuals throughout the patient care process.
• Must be proficient with Windows-style applications, various software packages specific to role
• Educated on and compliant with HIPAA regulations; maintains strict confidentiality of client information

Skills

• Ability to communicate effectively in English, both verbally and in writing
• Basic computer skills and knowledge
• Dependability
• Confidentiality
• Excellent writing and proofreading skills
• Solid calendaring, organizational and multi-tasking skills
• Ability to work efficiently and meet deadlines
• Detail-oriented
• Ability to prepare responses to requests for information

Physical Demands

• The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
• While performing the duties of this job, the employee is regularly required to talk and hear.
• This position is very active and requires repetitive motions, standing, walking, bending, kneeling and stooping all day.
• The employee must frequently lift or move items weighing up to 50 pounds.