MEDICAL INSURANCE SPECIALIST

Victoria Orthopedic Center is a busy Orthopedic Surgical medical practice. We are seeking a detail-oriented Insurance Clerk to manage workers' compensation referrals, insurance communications, TWCC forms, and the incoming fax server.

Key Responsibilities:

Receive and process workers' compensation referrals and intake information from referring physicians, insurance adjusters, employers, and case managers. Verify and document insurance/claim details (claim numbers, adjuster contact info, employer information, authorization status). Ensure all required TWCC forms are completed, signed, and filed according to regulatory timelines and practice protocols. Communicate with referring providers and adjusters to obtain missing information and authorizations.

Manage incoming fax server:

monitor incoming faxes, correctly distribute to appropriate staff/providers, and ensure timely scanning and upload into the patient's electronic/chart record. Maintain organized electronic and paper filing of workers' compensation documentation and correspondence. Track outstanding documents and follow up to meet deadlines and maintain claim integrity. Assist front-desk and clinical staff with workers' comp insurance questions and claim-related scheduling as needed. Maintain confidentiality and comply with HIPAA and TWCC regulations.

Preferred Qualifications:

1-3 years experience working with workers' compensation claims, medical billing, or in a medical office. Familiarity with TWCC forms and Texas workers' compensation procedures strongly preferred. Proficient with electronic medical records (EMR), document scanning, and basic office software (MS Office). Experience managing a fax server or digital fax system and scanning workflows. Strong attention to detail, organizational skills, and ability to prioritize tasks. Excellent written and verbal communication skills and professional phone demeanor.

Working Conditions:

Fast-paced medical office environment.

Pay:

$17.00 - $20.00 per hour

Benefits:

401(k) matching Dental insurance Health insurance Vision insurance

Work Location:

In person