Worker’s Compensation Referral Coordinator

Job Description: Worker’s Compensation Referral Coordinator

FLSA Status: Non-Exempt

Supervision Received: Business Office Manager

Supervision Exercised: N/A

Position Summary

Responsible for facilitation of medical authorizations by workers’ compensation carriers for services rendered to patients covered under workers’ compensation claims.

Essential Functions

• Receive and manage referrals for LOS physicians including initiation of approval by workers compensation agency/third party, patient registration and scheduling patient appointments.
• Communicates with adjusters, patients, attorneys, physician staff and physicians as well as other work comp staff as needed to clarify referral requests.
• Maintains goal of scheduling appointments immediately upon receipt of a referral approval. For acute/urgent injuries, get with the work comp team lead and/or appropriate work comp coordinator to determine if we must move forward with scheduling prior to official approval receipt.
• Obtain appropriate medical records prior to patient appointment or in order to obtain approval from the provider prior to patient scheduling.
• Assist in maintaining goals for quality patient care, patient satisfaction, and treatment compliance.
• Assist the workers’ compensation coordinators as needed and per availability.
• Answer phone and appropriately handle incoming workers’ compensation phone calls.
• Maintains patient confidentiality.

Requirements

EDUCATION

High school diploma or GED

EXPERIENCE

• One-year experience in appointment scheduling, preferably in a medical setting.

REQUIREMENTS

• Medical office experience. Knowledge of workers compensation processes and guidelines.

KNOWLEDGE

• Knowledge of the physician billing processes, 1010A’s and 1009’s.
• Knowledge of computer systems.
• Advanced computer knowledge, including Window based programs.

SKILLS

• Skill in customer service and an understanding of LOS’ code of conduct.
• Skill in using computer programs and applications including Microsoft Excel, Microsoft Word and Outlook.
• Skill in establishing good working relationships with both internal and external customers.

ABILITIES

• Ability to multi task in a fast- paced environment. Must be detailed oriented with strong organizational skills.
• Ability to understand patient demographic information and determine insurance eligibility.
• Ability to work independently and demonstrate the ability to analyze data.

ENVIRONMENTAL/WORKING CONDITIONS

• Normal office environment.

PHYSICAL/MENTAL DEMANDS

• Requires sitting and standing associated with a normal office environment. Some bending and stretching required. Manual dexterity using a calculator and computer keyboard.

This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.