Job Description
Job DescriptionDescription:
Job Summary: We are seeking an experienced Workers' Compensation Specialist to work in our Carrollton location. The Workers' Compensation Specialist is the liaison between the patient, insurance carrier, and physician and works in a fast-paced position. Onsite role
Key Functions:
- Obtains complete and accurate patient and injury information before scheduling appointments. Creates and maintains a Medical Chart on all workers comp patients.
- Verifies work related injury information with proper employer personnel.
- Verifies eligibility of injury and insurance benefits with insurance carrier representative.
- Translates between provider and patient as needed.
- Obtains correct insurance carrier billing address and claim number if assigned.
- Ensures proper documentation is attached to billing claims before submission or re- submission of the claims.
- Enters complete and accurate demographics into the billing system to ensure proper billing before the patient's first visit.
- Obtains pre-certifications and authorizations for treatment on a daily basis.
- Ensures completion of all TWCC required forms.
- Performs various collection activities to ensure payment is received and posted for each account. Contacts carriers, patients, or employers as needed to obtain/provide account information.
- Interprets appointment request and schedules patient appointment based on clinic policies. Identifies any problems with making the appointment and advises Physician and/or Manager.
- Checks answering service & reminder call email each morning for patient messages.
- Obtains patient's demographic information, insurance policy and medical issue.
- Informs patient about new patient and payment policies & referrals.
- Verifies insurance for same day add-on appointments.
- Relays relevant information to the Clinic Front Desk, Medical Records and appropriate internal staff when adding or changing an appointment.
- Provides any special needs of the patient to the Physician.
- Answers telephone, screens calls, takes messages, transfers calls to the appropriate area and provides information to keep the patient and clinic staff fully advised regarding appointments scheduled.
- Answers questions regarding patient appointments as requested.
- Makes necessary patient and/or policyholder information corrections in the Appointment System as necessary and advises the Patient and Billing.
- Safeguards patient information and ensures all information remains confidential.
- Request assistance from the Biller or Collectors for difficult account billing questions.
- Participates in office meetings and educational activities.
- Maintains work area in neat and orderly manner.
Requirements
- High School Diploma or GED, required.
- Must have Worker's Comp experience in a clinical setting-Strongly Preferred
- Referral Intake experience in an ortho setting preferred.
- Graduate of accredited program in Medical Administration, preferred.
- Knowledge of TWCC rulings and forms, strongly preferred.
- Ability to read, understand and master policies and regulations.
- Ability to use patient management systems and computer software (e.g., patient billing & collecting system, electronic medical record system, word processing).
- Ability to interact and communicate well with patients, staff, and vendors..(.)
Requirements:
- High School Diploma or GED, required.
- Must have Worker's Comp experience in a clinical setting-Strongly Preferred
- Referral Intake experience in an ortho setting preferred.
- Graduate of accredited program in Medical Administration, preferred.
- Knowledge of TWCC rulings and forms, strongly preferred.
- Ability to read, understand and master policies and regulations.
- Ability to use patient management systems and computer software (e.g., patient billing & collecting system, electronic medical record system, word processing).
- Ability to interact and communicate well with patients, staff, and vendors.