Workers' Comp Coordinator APN

Overview

As part of the Workers’ Compensation coordination team, this role contributes to the collective management of scheduling, authorization requests, and care coordination for injured workers. The team communicates clearly among patients, healthcare providers, workers’ compensation carriers, case managers, and attorneys—supporting timely claims processing and appropriate delivery of medical services. Team members share responsibilities for handling medical records, documentation, and administrative tasks to promote efficient clinic workflows and maintain regulatory compliance.

• Collect and accurately input patient demographics, payer/claim information, and billing details to ensure appointments and services are processed correctly.
• Obtain medical records and documentation related to the injury and prior treatment to support continuity of care.
• Provide patients, adjusters, and nurse case managers with pre-registration instructions and clinic directions.
• Coordinate and schedule workers’ compensation appointments within provider schedules, ensuring patient flow is efficient and aligned with individual care needs.
• Maintain oversight of WC appointments to match the patient’s status and treatment requirements.
• Ensure all necessary medical documentation is collected and uploaded to the patient’s chart prior to appointments.
• Prepare and organize the patient file to support provider evaluation and treatment planning.
• Submit prior authorization requests for provider-ordered services, including ancillary services (e.g., MRI, CT, Physical Therapy, PRP injections, joint medications, referrals), surgical procedures, and office visits, with supporting medical documentation and work status reports.
• Collaborate with adjusters and nurse case managers to obtain timely approvals and submit appeals when necessary, documenting all activity in the EHR.
• Coordinate approved services with external providers and communicate follow-up instructions to patients, ensuring necessary records are received and documented.
• Act as a liaison between patients, providers, adjusters, nurse case managers, and attorneys to ensure cohesive communication and follow-through.
• Maintain ongoing communication with all parties, document all case-related updates in the EHR, and manage calendars and tasks to follow treatment plans and timelines.
• Ensure strict confidentiality and proper handling of sensitive case information and records.
• Understand multiple clinic workflows and assist with communications, administrative tasks, and cross-departmental coordination as needed.
• Perform other related duties as assigned and assist in other departments as deemed necessary by management.

• Prior healthcare experience required; experience with medical authorizations and/or care coordination preferred.
• Workers’ compensation experience preferred.
• Proven administrative or assistant experience in a medical or clinical setting.
• Ability to read and interpret electronic medical records and treatment plans.
• Educated on and compliant with HIPAA regulations; maintains strict patient confidentiality.
• Demonstrates professionalism in all duties, interactions, and communications.
• Strong customer service orientation with the ability to communicate effectively across roles and settings.
• Dependable, adaptable, and able to work collaboratively in a team environment.

• High school diploma, GED, or equivalent required. Additional degrees, certifications, or training may be considered toward qualifications.
• Must have computer skills and dexterity for data entry and retrieval of patient information.
• Proficiency with Windows-based applications and medical software systems; previous experience with medical software and scheduling platforms preferred.
• Understanding and compliance with all HIPAA and patient privacy regulations.
• Ability to read and interpret electronic medical records and treatment plans (duplicated for emphasis).

• Excellent verbal and written communication skills.
• Strong organizational, calendaring, and administrative skills.
• High attention to detail with accurate recordkeeping and documentation.
• Excellent time management…