OrthoNebraska is currently searching for a Workers Compensation Specialist to join our team! The Workers Compensation Specialist is a part of our Patient Financial Services Department. The position is responsible for the accurate and timely filling of invoices to the employers and/or Third Party for services rendered at OrthoNebraska. If you think this might be a fit for you, apply today!
Essential Duties and Responsibilities
- Obtain records and referral/authorization for treatment of Workers Compensation patient.
- Review worker’s compensation accounts, ensuring that all necessary documentation is present for billing, e.g. First Report of Injury, work comp claim number.
- Acquire relevant information and records for MVA or Third-Party liabilities.
- Examines explanation of benefits if claim is denied, calls claims adjuster to verify if claim was denied correctly. If claim was denied correctly, forwards to billing office to file with patient’s health insurance.
- Contacts carriers, patients, or other relevant contacts by phone, email, or letter to resolve unpaid claims, application problems and other related items as required.
- Ensure case manager/adjuster or employer has set up interpreter services if needed for patient.
- Coordinate with clinical staff to obtain approval to schedule workers compensation patients as appropriate.
- Assist Customer Service/Employers/Third Party Administrators with questions concerning Worker’s Compensation accounts/claims.
- Assist Payment Posting with correct posting of payments when necessary.
- Assist Clinics when questions arise concerning Worker’s Compensation visits.
- Contact Employer/Payor on outstanding A.R. balances when not paid.
- Ensure that month end goals are met in a timely manner.
- Maintain patient privacy and confidentiality under requirements of federal and state law, including HIPAA.
Here’s what makes for an ideal candidate:
- High school graduate or equivalent required.
- Previous Workers Compensation preferred
- 1 to 2 years of previous general office work strongly preferred.
- Develop and maintain working relationships with Workers Compensation Insurance adjuster, Case Managers, Employer Risk Managers.
- Knowledge of operation (user level) personal computer programs.
- Knowledge of medical terminology preferred.
- Must be able to demonstrate calm, rational thinking and clear communication when faced with deadlines and customer demands.
- Must be capable of responding to frequent priority changes and multiple deadlines.
- Team environment requires total participation by all members in problem solving and decision-making.