Position Overview
The Workers' Compensation Associate at Comprehensive Orthopaedics plays a crucial role in managing and processing workers' compensation claims related to orthopedic injuries and conditions. This position requires a strong understanding of medical terminology, the ability to multi-task, and excellent communication skills to liaise between patients, medical staff, and insurance companies.
The Associate manages the end-to-end lifecycle of the claim, ensuring a smooth and efficient process for the patient, provider, and workers’ compensation adjuster, directly contributing to the overall success of our practice.
Key Responsibilities
Intake, Scheduling & Documentation
- Manage the dedicated Workers' Comp phone line, voicemails, and emails.
- Enter new referrals into the EMR with accurate claim, employer, and adjuster details.
- Schedule consultations, follow-ups, and Respondent Medical Exams (RME).
- Sort and route incoming faxes, emails, and medical records to appropriate charts.
Authorizations & Care Coordination
- Secure prior authorizations for appointments, diagnostics, and procedures.
- Audit patient charts prior to visits to verify active authorizations and prevent care delays.
- Act as the primary liaison between providers, adjusters, and Nurse Case Managers
- Distribute progress notes, operative reports, and work status updates to authorized parties.
Financials, Billing & Reporting
- Prepare impairment/rating reports and collect required prepayments from carriers.
Admin & Compliance
- Support the Workers’ Comp Lead on special projects and attend mandatory staff meetings.
Qualifications and Requirements
- Direct experience in medical/orthopedic Workers' Compensation
- Strong grasp of medical terminology and orthopedic injuries
- Experience with Epic and systems such as Microsoft Office (Word/Excel).
- High attention to detail, strong multi-tasking skills, and excellent customer service.
- Ability to handle sensitive, confidential patient data with strict HIPAA discretion.
Job Type: Full-time
Pay: $20.00 - $26.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Work Location: In person
