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SalaryWorkers Compensation Specialist
Job Summary:
Under the direction of the Work Comp Department manager, this employee is responsible for the coordination of services required by patients, their employers, and case management organizations to create a streamlined approach for Work Comp Healthcare. Regular attendance is an essential part of this job.
Essential Functions:
Prints Pre-cert forms from computer
Prints all work comp policy forms
Schedules all work comp appointments
Pre-certs any diagnostic tests, surgeries, consults, referrals to another physician
Schedules Functional Capacity Exams (FCEs) at Tri-State Orthopaedics
Handles internal work comp claims
Faxes all therapy (work comp) notes
Faxes all work comp dictations and work status updates
Calculates and dictates Permanent Partial Impairment (PPI) rating (with doctor approval)
Dictates letters for physicians
Schedules and tracks Independent Medical Evaluation (IME) records and prepays (x-rays)
Sort faxes from Scan place
Handles voicemails/email messages
Answers questions/concerns for insurance companies, case managers, and employees
Speaks with disgruntled patients in person or via phone
Explains PPI and/or Maximum Medical Improvement (MMI) to patients
Verifies work comp injury
Helps facilitate solutions to problems
Schedules and attends external site visits with employers and physicians
Meets with employers/insurance, case managers
Build and maintain strong business relationships with key accounts
Meets with doctors
Reschedules appointments for patients and notifies patient, case manager, and employer insurance when office cancelled or changed
Retrieves reports
Scans work comp paperwork, double check to see that all paperwork made it to the chart
Calls dates and times for scheduled procedures
Enters employer insurance and all appropriate notes with contact information
Gains expertise and knowledge to anticipate and effectively manage work comp growth opportunities
Additional Responsibilities:
Covers other associates when needed
Promotes Tri-State Orthopaedics workers compensation services
Attends seminars/conferences to stay current on work comp practices
Job Qualifications:
Prior experience in the medical field required
Prior case management experience managing work comp cases preferred
Familiarity with Indiana Work Comp laws preferred
Strong verbal, written, interpersonal skills
Strong problem solving skills
Basic computer skills
Excellent time management and organizational skills
Ability to work collaboratively with a multi-functional team including all doctors, nurses, case managers and employers in a professional manner
Job Summary:
Under the direction of the Work Comp Department manager, this employee is responsible for the coordination of services required by patients, their employers, and case management organizations to create a streamlined approach for Work Comp Healthcare. Regular attendance is an essential part of this job.
Essential Functions:
Prints Pre-cert forms from computer
Prints all work comp policy forms
Schedules all work comp appointments
Pre-certs any diagnostic tests, surgeries, consults, referrals to another physician
Schedules Functional Capacity Exams (FCEs) at Tri-State Orthopaedics
Handles internal work comp claims
Faxes all therapy (work comp) notes
Faxes all work comp dictations and work status updates
Calculates and dictates Permanent Partial Impairment (PPI) rating (with doctor approval)
Dictates letters for physicians
Schedules and tracks Independent Medical Evaluation (IME) records and prepays (x-rays)
Sort faxes from Scan place
Handles voicemails/email messages
Answers questions/concerns for insurance companies, case managers, and employees
Speaks with disgruntled patients in person or via phone
Explains PPI and/or Maximum Medical Improvement (MMI) to patients
Verifies work comp injury
Helps facilitate solutions to problems
Schedules and attends external site visits with employers and physicians
Meets with employers/insurance, case managers
Build and maintain strong business relationships with key accounts
Meets with doctors
Reschedules appointments for patients and notifies patient, case manager, and employer insurance when office cancelled or changed
Retrieves reports
Scans work comp paperwork, double check to see that all paperwork made it to the chart
Calls dates and times for scheduled procedures
Enters employer insurance and all appropriate notes with contact information
Gains expertise and knowledge to anticipate and effectively manage work comp growth opportunities
Additional Responsibilities:
Covers other associates when needed
Promotes Tri-State Orthopaedics workers compensation services
Attends seminars/conferences to stay current on work comp practices
- The preceding examples are representative of the assignments performed by this position and are not intended to be all-inclusive.
Job Qualifications:
Prior experience in the medical field required
Prior case management experience managing work comp cases preferred
Familiarity with Indiana Work Comp laws preferred
Strong verbal, written, interpersonal skills
Strong problem solving skills
Basic computer skills
Excellent time management and organizational skills
Ability to work collaboratively with a multi-functional team including all doctors, nurses, case managers and employers in a professional manner
