Worker Compensation Specialist Position Available In Lee, Florida

ESSENTIAL FUNCTIONS INCLUDE BUT ARE NOT LIMITED TO

• Reviews worker’s compensation accounts and forms for accuracy and completeness.
• Takes inbound calls from patients and insurance to set up patient charts, schedule appointments.
• Answers questions and provides information pertaining to well-defined areas, which require interpretation of the policy.
• Responsible for sending documentation and orders for each patient visit to the correct carrier.
• Interacts with claims adjustors to verify patient’s work status and scheduled appointments.
• Communicates verbally and in writing regarding the interpretation of local and out-of-state guidelines and policies.
• Maintains all records and reports.
• Responds to telephone calls from internal staff, patients, adjusters, and case managers.
• Obtains authorizations for initial visits, surgeries, and physical therapy.

EDUCATION

• High school diploma/GED or equivalent working knowledge preferred.

EXPERIENCE

• One-year medical billing or medical business office experience in a physician office or hospital environment; OR
• Worker’s Compensation experience is preferred.

REQUIREMENTS

• Excellent verbal and written communication skills.
• Experience working with Microsoft applications including Word. Excel, and Outlook.
• Ability to work productively in a fast-paced environment.
• Ability to learn and retain company policies, state and federal policies, and workflow processes.

KNOWLEDGE

• Knowledge of worker’s compensation and/or healthcare insurance
• Knowledge of billing and related functions and tasks.
• Knowledge of worker’s compensation processes and requirements.
• Knowledge of payer-specific requirements, state and federal regulations.
• Knowledge of physician group operation and clinic policies.
• Knowledge of authorization and verification processes. SKILLS
• Skill in the billing authorization process.
• Skill in obtaining necessary approvals for worker’s compensation to reduce denials.
• skill in the collection process for worker’s compensation.
• Skill in Microsoft applications, specifically Excel and Access.

ABILITIES

• Ability to proficiently use arithmetic calculations in data collection and interpretation.
• Ability to use interpersonal skills to establish/maintain cooperative relationships with patients, families, physicians, management, and other staff.
• Ability to communicate openly and honestly with management and staff.

PHYSICAL/MENTAL DEMANDS

• This can occasionally be a high-stress work area requiring the ability to make quick decisions while being organized and prioritizing appropriately.
• Requires sitting and standing associated with a normal office environment.
• Some bending and stretching are required.
• Manual dexterity using a calculator and computer keyboard.