Position Summary:  The Workers' Compensation Care Coordinator serves as a key liaison between patients, insurance carriers, and internal departments to ensure accurate coordination of care and documentation for workers' compensation cases. This role requires a strong understanding of state guidelines, attention to detail, and excellent communication skills. 

The work comp specialist will work through procedures and standards to improve efficiency, effectiveness, and Compliance within the doctor’s offices, scheduling all new work comp patients for the company and obtaining authorizations for all of their studies and procedures preformed by NASA. Will be responsible to make sure work is done and completed in a timely manner. Must meet and maintain all job responsibilities on a daily basis. Must be compliant with all the policy and procedures as they pertain to work comp. Must be able to train and cross-train individuals. Must support Doctors, staff and office managers.

Classification:          Non-Exempt – In accordance with the requirements of the Fair Labor Standards Act.

Reports To:              Office Manager

Qualifications:         Requires a minimum of 2 years experience in a doctor’s office or related field. Must be familiar with concepts, practices, and procedures for all Workers’ Compensation payers.  Relies on extensive experience and judgment to plan. A wide degree of creativity and latitude is expected. Responsible troubleshooter, problem solver, and not a complainer. Must have a very positive personality and be able to express this positive image via extensive daily phone use. Must be able to train individuals and cross train individuals to do multi-tasks. Efficient with Word, Excel, and medical software experience helpful. Must be able to sit for long periods of time and use computer for at least 8 hours a day. Able to handle very high volumes of phone calls, emails, and faxed requests with a high degree of accuracy and timeliness. Must also be an extremely organized individual.

 Essential Functions:          

·        Handle inbound phone calls from patients and insurance adjusters to register new cases and schedule appointments.

·        Review workers' compensation forms and patient accounts for accuracy and completeness.

·        Send required documentation and physician orders to insurance carriers and adjusters following each patient visit.

·        Faxing and Scanning of all documents

·        Collaborate and communicate with claims adjusters and case managers to confirm work status, Maximum Medical Improvement (MMI), and treatment plans. 

·        Establish relationships with adjustors, companies and Nurse Managers as well as meets with them as needed.

·        Negotiates procedures at NASA

·        Interpret and communicate state-specific workers' compensation regulations both verbally and in writing.

·        Maintain organized and up-to-date patient records and accounts.

·        Respond to internal inquiries related to workers’ compensation procedures and cases.

·        Secure authorizations for medical services as needed.

·        Dispense in-house medications in accordance with company policy and applicable regulations.

Additional Responsibilities: Assumes other duties as assigned by the Office Manager, CEO, or Partners.

*Note: This job description can be developed and expanded depending upon the necessity of the work at the discretion of the CEO or Partners