Job Title: Workers’ Compensation Authorization Coordinator
Reports to: Workers’ Compensation Manager
GENERAL SUMMARY OF DUTIES: The Workers’ Compensation Authorization Coordinator is responsible for obtaining pre-authorization for all diagnostics testing and surgical requests.
Essential Job Functions:
- Develop and maintain positive working relationships with case managers, adjusters, employers, vendors.
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Obtain pre-authorization for all diagnostics, and surgical requests.
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Understanding the process and working with Utilization Review.
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Phone triage per scenario, document patient questions, consult with medical providers for appropriate and thorough documentation, and return patient phone calls in a timely manner along with verifying patient demographics and insurance information.
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Understand & apply workers’ compensation jurisdiction laws and regulations for Mass & RI.
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Additional duties as assigned by the Manager to meet department needs.
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Requirements:
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High School education or equivalent required.
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2-3 years relevant work experience in a medical office setting or related workers' compensation experience required.
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1+ year obtaining prior authorizations required, experience supporting an orthopedic office preferred.
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Must be self-directed and able to work with minimal supervision and direction.
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Skills in oral and written communication.
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Knowledge of computer applications for Excel spreadsheets, and word processing.
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Must be able to travel to all sites if/when necessary.
