Workers Compensation Specialist

Description:

Job Summary: We are seeking an experienced Workers' Compensation Specialist to work in OrthoTexas's central Business Office in Carrollton. The Workers' Compensation Specialist is the liaison between the patient, insurance carrier, and physician and works in a fast-paced position.

• Obtains complete and accurate patient and injury information before scheduling appointments. Creates and maintains a Medical Chart on all workers comp patients.
• Verifies work related injury information with proper employer personnel.
• Verifies eligibility of injury and insurance benefits with insurance carrier representative.
• Translate between provider and patient as needed.
• Obtains correct insurance carrier billing address and claim number if assigned.
• Ensures proper documentation is attached to billing claims before submission or re- submission of the claims.
• Enters complete and accurate demographics into the billing system to ensure proper billing before the patient's first visit.
• Obtains pre-certifications and authorizations for treatment on a daily basis.
• Ensures completion of all TWCC required forms.
• Performs various collection activities to ensure payment is received and posted for each account. Contacts carriers, patients, or employers as needed to obtain/provide account information.
• Interprets appointment request and schedules patient appointment based on clinic policies. Identifies any problems with making the appointment and advises Physician and/or Manager.
• Checks answering service & reminder call email each morning for patient messages.
• Obtains patient's demographic information, insurance policy and medical issue.
• Informs patient about new patient and payment policies & referrals.
• Verifies insurance for same day add-on appointments.

Requirements:

• High School Diploma or GED, required.
• Graduate of accredited program in Medical Administration, preferred
• Bilingual preferred, not required
• Knowledge of TWCC rulings and forms, required.
• Ability to read, understand and master policies and regulations.
• Ability to use patient management systems and computer software (e.g., patient billing & collecting system, electronic medical record system, word processing).
• Ability to interact and communicate well with patients, staff, and vendors.