Orthopedic Workers' Comp Claims Specialist

Boston Medical Center (BMC)

Boston (MA)

On-site

USD 34,440 - 50,971

Full time

14 days+

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Job summary

Boston Medical Center seeks an Orthopedic Surgery Workers Compensation Specialist to support clerical and administrative tasks for workers' compensation cases within the Orthopedic Clinic. You will process claims, generate reports, and coordinate communications among patients, claim representatives, and providers.

The role requires at least three years of clerical and insurance management experience, with preferred workers' comp adjuster experience.

Qualifications

Associates degree required; Bachelor’s degree preferred.
Minimum three years of clerical and insurance management experience.
At least one year of workers' compensation adjuster or case manager experience.
Experience in an Orthopedic clinical setting is a plus; Workers’ Compensation certification is preferred but not required.
Knowledge of workers’ compensation program administration and applicable laws.
Strong communication and organizational skills; ability to interpret and disseminate information.

Responsibilities

Develop, maintain, and manage the internal workers' comp program.
Investigate and process workers' comp claims from initial evaluation through discharge.
Communicate with employees, managers, insurers, medical providers, surgeons, attorneys, and management.
Coordinate with the Billing Director on investigations, settlements, and litigation.
Maintain and close the communication loop on claims status and denials.