Workers Compensation Specialist

Tennessee Orthopaedic Alliance (TOA) is the largest orthopaedic surgery group in Tennessee, specializing in the diagnosis and treatment of musculoskeletal disorders and injuries. With over 90 years of service, TOA operates 20+ locations across the state, fostering stability, impactful work, a positive environment, and comprehensive total rewards.

About the role

The Workers' Compensation Specialist will coordinate care for TOA patients utilizing Workers' Compensation benefits, ensuring seamless communication between patients, TOA, and carriers to facilitate appropriate and complication-free scheduling.

Responsibilities

• Field initial outreach from injured workers or their employers to facilitate TOA services.
• Obtain authorization and pre-certification for services such as examinations, physical therapy, diagnostics, and other ancillary services.
• Schedule workers' compensation appointments, follow-ups, and coordinate ancillary services.
• Collaborate with employers, insurance adjusters, attorneys, and physicians on workers' compensation case issues.
• Manage workflow of assigned cases, including handling telephone and email inquiries from employers, insurance carriers, case managers, and attorneys.
• Obtain and enter pertinent data into computer systems, ensuring timely completion and distribution of necessary documentation.

Requirements

• A Bachelor’s degree is preferred; a high school diploma or equivalent is required.
• At least one year of medical office administration or clinical experience is preferred, with experience in Workers' Compensation or an orthopaedic office a plus.
• Exceptional customer service and patient focus, ensuring positive encounters for patients, employers, and stakeholders.
• Ability to multi-task and operate in a fast-paced environment, handling high volumes of telephonic inquiries and documentation with accuracy.
• Knowledge of insurance, particularly workers' compensation and health insurance provisions, including collecting copayments, deductibles, coinsurance, and balances.
• Familiarity with administrative and clerical procedures, including experience with computer systems; EHR or NextGen experience is a plus.
• Strong attention to detail, ensuring accurate and swift documentation.
• Flexibility in work schedules to adjust to necessary clinic hours.
• Collaborative mindset, working closely with clinical and administrative teams to foster a high-performing environment.
• Energetic and enthusiastic demeanor, managing patient flow efficiently without compromising care.
• Dependability, with a commitment to punctuality and consistent attendance.

Benefits

• Comprehensive medical and dental coverage.
• Paid Time Off.
• 401(k) plan with company match, safe harbor match, and profit-sharing match.