Miniviasive Pain and Orthopedics is looking for a full-time, Workers Compensation Coordinator in Spring, Texas! The Worker’s Compensation Coordinator is responsible for assessing, coordinating, verifying, prior authorization, and finding the best approach when handling the patient’s worker’s compensation claim.

Essential Functions

Case Management

• Tracks, coordinate, and communicate patient’s claim.
• Completes registration, including claim information is updated appropriately in EMR software.
• Serves as the point of contact in multidisciplinary evaluation process which includes patient scheduling, third party communications, and internal communications.
• Contacts Worker’s Comp payers to ensure verification of coverage and prior authorization approval requirements are met.
• Communicates with patients on their claim status and coordinates best approach on their ongoing treatment plan.
• Identify problems and find the best solutions to meet patient’s needs/claim.
• Communicates with referral sources for proper handling of referral/claim.
• Manages the states of the accounts and identify/report any inconsistencies.
• Acts as the patient's advocate and address any barriers that prevent the best/compliant care plan.
• Coordinates and communicates potential incoming peer to peer requests and/or additional documentation needs per the payer’s request with internal providers.
• Requests, reviews, and submits necessary patient documentation as needed. e.g. FMLA, narrative reports, DWC073, DWC17 as well as any other necessary paperwork
• Reports statistics as required regarding worker’s compensation claims.
• Travel as necessary to other facilities.
• Performs other duties as assigned.
  
  

Workers Compensation

• Verify patient insurance coverage and update system accordingly to ensure a clean billing process.
• Prioritize incoming authorization requests according to urgency.
• Generate, verify, and oversee the complete procedure authorization/referral process.
• Obtain authorization by fax, payer website or by phone and follow up regularly on pending cases.
• Notify appropriate departments for approvals and denials.
• Initiate and assist with appeals for denied authorizations.
• Monitor provider network status and notify appropriate individuals of non-network status providers.
• Notify and coordinate peer-to-peer (P2P) requests with the appropriate department.
• Confirm accuracy of CPT and ICD-10 diagnoses in the procedure order
• Contact patients as needed to discuss authorization status
• Manages and resolves day-to-day issues pertaining to pre-authorization, as needed.
• Maintain, monitor, and update payer medical policy guidelines to manage authorization requirements.
• Requests, reviews, and submits necessary patient documentation as needed.
• Schedule and organize patient appointments and/or procedures according to physician and patient availability within the designated network.
• Utilizes ICD 10, CPT, HPCPS, modifiers and/or other codes according to coding guidelines.
• Communicates effectively with provider and/or all appropriate parties regarding missing information such as CPT, diagnoses codes, documents, operative reports, etc. to ensure proper authorization processing.
• Communicates effectively with other departments regarding changes and/or updates with patient accounts and status.
• Responds to billing inquiries.
  
  

Knowledge, Skills, And Abilities

• Strong organizational skills.
• Ability to handle stressful situations in a professional manner.
• Strong communication skills.
• Ability to model corporate values.
• Has a “can do” attitude.
• Strong attention to detail: being careful about detail and thorough in completing work tasks.
• Ability to work independently by guiding oneself with little or no supervision and depending one oneself to get things done.
• Ability to maintain records.
• Exceptional customer service and phone etiquette.
• Strong computer skills with proficiency in Microsoft Office, including Outlook, Excel, Word & eCW (EMR).
  
  

EDUCATION AND EXPERIENCE:

• High School Diploma or GED
• One (1) year in a medical office setting
  
  

Benefits Offered

• 3 Medical Plans
• 2 Dental Plans
• 1 Vision Plan
• Employee Assistance Program
• Short and Long-Term Disability Insurance
• Basic and Voluntary Life with AD&D Plan
• 401(k) with a 2-year vesting
• PTO + Holidays
  
  

Please Visit Our Website For More Information

minivasivepain.com

Minivasive Pain and Orthopedics is an outpatient clinic network serving the greater local Houston, TX area. Our teams strive to deliver personalized and compassionate care to meet our patients' individualized needs. At MPO, we continue to seek talented individuals who are passionate about making a difference and developing their clinical skillset. Come join our team at Minivasive Pain and Orthopedics and unlock your potential for excellence.

Compensation to be determined by the education, experience, knowledge, skills, and abilities of the applicant, internal equity, and alignment with market data.

Employment for this position is contingent upon the successful completion of a background check and drug screening.