Workers' Comp Coordinator Hospital - RH

Overview

The Workers Comp. Coordinator serves as the first point of contact for patients and nurse case managers in the clinic. This role coordinates scheduling requests, answers questions, responds to emails and referrals, manages medical records and imaging, and communicates the plan of care following patient encounters. The position requires collaboration with many team members to provide seamless support, data entry, and provider notification to ensure timely service within contract-mandated time frames.

• Oversee workers' compensation appointment types within provider schedules to ensure patient flow aligns with needs.
• Provide pre-registration instructions and directions to clinic locations for patients, nurse case managers, and adjusters.
• Efficiently and accurately gather and input patient demographic, payer, and other information to ensure correct appointments and billing.
• Obtain medical records and documents related to the injury and treatment prior to appointments to support continuity of care and clinic workflow.
• Obtain prior authorizations for ancillary services (MRI, CT, Physical Therapy, outside referrals, PRP injections, joint medications, etc.).
• Collaborate with the nurse case manager and adjuster to obtain prior authorizations and schedule procedures promptly.
• Schedule patient appointments in the clinic once injections, tests, and drug authorizations are approved.
• Document all steps in the prior authorization process in the computer for access by all employees.
• Manage calendars and schedules to ensure tasks stay on track and deadlines are met.
• Handle confidential information with integrity and discretion when liaising with professionals inside and outside the company.
• Assist with communications, administrative tasks, and scheduling related to each patient’s case.
• Act as a liaison with claims adjusters, attorneys, and patients to ensure medical plans and obligations are met to their satisfaction.
• Maintain documentation and correspondence in strict confidence.
• Support oversight of case records, including requesting documentation and managing workflow.
• Accurately document all communications and patient accounts of actions taken in the EHR.
• Maintain quality service by following organizational standards.
• Other duties as assigned.

• Action Orientation
• Communications
• Creativity/Innovation
• Critical Judgment
• Customer Orientation
• Interpersonal Skills
• Leadership
• Teamwork

• Excellent organizational skills
• Strong communications skills
• Strong customer service experience
• Excellent time management and ability to multi-task
• Attention to detail and problem-solving

• High school diploma, GED, or equivalent
• Proven admin or assistant experience
• Previous medical software experience
• Worker’s compensation experience preferred
• Additional degrees, training, or certifications may meet minimum qualifications
• Computer skills and dexterity for data entry and retrieval of patient information
• Effective verbal and written communication skills
• Proficiency with Windows-based software and role-specific tools
• HIPAA compliance and strict confidentiality of client information

• English communication (verbal and written)
• Basic computer skills
• Dependability
• Confidentiality
• Writing and proofreading
• Calendaring, organization, and multi-tasking
• Ability to work efficiently and meet deadlines
• Detail-oriented; ability to prepare responses to information requests

The physical demands described are representative of those required to perform the essential functions. The role involves talking and hearing, is very active, and requires repetitive motions, standing, walking, bending, kneeling, and stooping. The employee may frequently lift or move items weighing up to 50 pounds.