Healthcare Outcomes Performance Co. (HOPCo)

Worker Compensation Specialist

Wellington, FL, US

3 months ago
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Summary

Essential Functions

  • Reviews Worker’s Compensation accounts and forms for accuracy and completeness.
  • Answers questions and provides information pertaining to well-defined areas, which require interpretation of policy.
  • Responsible for processing 102 forms and mailing copies to the Industrial Commission.
  • Interacts with claims adjustors to verify patients work status and scheduled appointments.
  • Communicates verbally and in writing regarding interpretation of local and out of state guidelines and policies.
  • Maintains all records and reports.
  • Responds to telephone calls from internal staff, patients, adjustors and case managers.
  • Obtains authorizations for initial visits, surgeries and physical therapy.
  • The job holder must demonstrate current competencies for job position
  • High school diploma/GED or equivalent working knowledge preferred.


Experience

  • One-year medical billing or medical business office experience in physician office or hospital environment.


KNOWLEDGE

  • Knowledge of billing and related functions and tasks.
  • Knowledge of large physician group operation and clinic policies.
  • Knowledge of Worker’s Compensation processes and requirements.
  • Knowledge of payer specific requirements, state and federal regulations.
  • Knowledge of authorization and verification processes.


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