Resurgens Orthopaedics
Workers Compensation Specialist
Resurgens Orthopaedics, Arlington, Texas, United States, 76000
Job Type
Full-time
Description
JOB SUMMARY:
Responsible for transitional phases of the worker's compensation program within the office. Beginning with the verification of coverage on each worker's compensation patient and the filing of all required DWC (Division of Workers' Compensation) patient status forms, to the necessary updates with insurance companies and case managers.
RESPONSIBILITIES INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING:
Receives referrals from outside sources for new patients. Verifies coverage and treatment designated with insurance adjusters prior to appointment and schedules initial appointment.Reviews and provides status of treatment to insurance adjusters and case managers when requested. Remains in close contact with patients during entire course of treatment.Monitors changes in the rules of the Division of Workers' CompensationUpdates key personnel regarding changes in requirements of the DWCCoordinate with AOA business office to evaluate and resolve reimbursement issuesMaintain patient files in the EMR system, ensuring accuracy of all information related to Workers' Compensation casesComplete and submit DWC required reports in accordance with approved DWC regulationsSolves difficult problems involving Worker's Compensation patients, whether relating to work status or claim problemsMaintains a working knowledge and complies with all established policies and procedures of the DWCMust understand a PLN11 and PLN1Must be able to communicate with doctors and their clinical teamsResponds to patient/adjustor/insurance questions in a timely mannerAttends required staff meetingsMaintains patient confidentialityKnowledge of surgery/testing preauthorization processAdditional responsibilities as assigned by managerRequirements
EDUCATIONAL REQUIREMENTS:
High School Diploma/GED or equivalent experienceQUALIFICATIONS AND EXPERIENCE:
Must have 1-2 years Work Comp Experience with physician clinic setting
(Required)Athena experience is a plusKnowledge of the Division of Workers' Compensation (DWC) rules and regulationsExperience in filing required DWC reports with employees, insurance companies, and the DWCBackground in medical terminology, preferably orthopedicsWorking knowledge of AOA's practice management systemKnowledge of CPT and ICD-10 coding for the specialtyPleasant speaking voice and demeanorExperience in a project-oriented position preferredNeat, professional appearanceStrong written and verbal communication skills
Full-time
Description
JOB SUMMARY:
Responsible for transitional phases of the worker's compensation program within the office. Beginning with the verification of coverage on each worker's compensation patient and the filing of all required DWC (Division of Workers' Compensation) patient status forms, to the necessary updates with insurance companies and case managers.
RESPONSIBILITIES INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING:
Receives referrals from outside sources for new patients. Verifies coverage and treatment designated with insurance adjusters prior to appointment and schedules initial appointment.Reviews and provides status of treatment to insurance adjusters and case managers when requested. Remains in close contact with patients during entire course of treatment.Monitors changes in the rules of the Division of Workers' CompensationUpdates key personnel regarding changes in requirements of the DWCCoordinate with AOA business office to evaluate and resolve reimbursement issuesMaintain patient files in the EMR system, ensuring accuracy of all information related to Workers' Compensation casesComplete and submit DWC required reports in accordance with approved DWC regulationsSolves difficult problems involving Worker's Compensation patients, whether relating to work status or claim problemsMaintains a working knowledge and complies with all established policies and procedures of the DWCMust understand a PLN11 and PLN1Must be able to communicate with doctors and their clinical teamsResponds to patient/adjustor/insurance questions in a timely mannerAttends required staff meetingsMaintains patient confidentialityKnowledge of surgery/testing preauthorization processAdditional responsibilities as assigned by managerRequirements
EDUCATIONAL REQUIREMENTS:
High School Diploma/GED or equivalent experienceQUALIFICATIONS AND EXPERIENCE:
Must have 1-2 years Work Comp Experience with physician clinic setting
(Required)Athena experience is a plusKnowledge of the Division of Workers' Compensation (DWC) rules and regulationsExperience in filing required DWC reports with employees, insurance companies, and the DWCBackground in medical terminology, preferably orthopedicsWorking knowledge of AOA's practice management systemKnowledge of CPT and ICD-10 coding for the specialtyPleasant speaking voice and demeanorExperience in a project-oriented position preferredNeat, professional appearanceStrong written and verbal communication skills