Company Overview
Agility Orthopedics has established itself as a premier provider of orthopedic care for over four decades. Located in a modern facility equipped with advanced digital imaging and expanded physical therapy services, our team is committed to delivering exceptional patient outcomes and innovative treatment options.
Position Summary
We're growing and expanding, and we're looking for a Workers' Compensation Specialist to join our team!
The Workers' Compensation Specialist serves as the primary point of contact for workers' compensation referrals and coordinates all aspects of patient care related to workers' compensation claims. This role is responsible for verifying claims, managing referrals within the EPIC electronic medical record (EMR), obtaining authorizations, communicating with adjusters and case managers, and ensuring timely follow-up to facilitate patient access to care and reimbursement.
Essential Duties and Responsibilities
- Answer incoming phone calls from workers' compensation adjusters, peer-to-peer schedulers, patients, employers, and case managers.
- Manage the daily schedule work queue in EPIC EMR for new and incoming workers' compensation referrals.
Coordinate and obtain required authorizations and approvals for services.
- Monitor authorization status and perform timely follow-up with insurance carriers, adjusters, and employers.
- Negotiate fees when appropriate in accordance with organizational policies and payer requirements.
- Follow up on outstanding claims, authorizations, and reimbursement issues to ensure prompt resolution.
- Provide exceptional customer service while maintaining confidentiality and compliance with HIPAA regulations.
- Perform other duties as assigned.
Qualifications
- High school diploma or equivalent required; associate's degree preferred.
- Minimum of 2 years of experience in workers' compensation, insurance authorization, or healthcare administration preferred.
- Experience using EPIC EMR (required).
- Knowledge of workers' compensation claims processing, authorizations, and insurance verification.
- Strong communication, negotiation, and customer service skills.
- Excellent organizational skills with the ability to manage multiple priorities in a fast-paced environment.
- Proficient in Microsoft Office applications and standard office equipment.
- Ability to maintain confidentiality and exercise sound judgment when handling sensitive information.
Core Competencies
- Customer service excellence
- Attention to detail
- Problem-solving and critical thinking
- Time management and organization
- Effective verbal and written communication
- Team collaboration
Pay: $22.00 - $28.00 per hour
Benefits:
- 401(k)
- AD&D insurance
- Dental insurance
- Dependent care reimbursement
- Disability insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Referral program
- Vision insurance
Education:
Experience:
- EPIC EMR: 1 year (Required)
Language:
- more than 1 language (Preferred)
Work Location: In person
