Reimbursement Specialist - Workers' Compensation

TSAOG Orthopaedics & Spine; San Antonio (TX); On-site; USD 40,000 - 60,000; Full time

Job summary

TSAOG Orthopaedics & Spine is seeking a Professional Reimbursement Specialist for Workers' Compensation. The role focuses on managing incoming calls, referrals, and documentation to ensure proper processing and scheduling of patient cases.

The ideal candidate will have strong customer service, data entry accuracy, and proficiency with Microsoft Office. The position requires adherence to healthcare regulations and confidentiality, with opportunities to contribute to process improvements.

Qualifications

• Must have strong customer service skills and the ability to communicate effectively.
• Proficient data entry skills and accurate documentation are required.
• Prolonged sitting, repetitive motion, and phone handling are expected tasks.

Responsibilities

• Manage workers' compensation calls, faxes, emails and referrals.
• Communicate with adjusters, nurse case managers, referral sources, and physicians with required information.
• Assist other departments by providing or verifying workers' comp information as needed.
• Respond to and document patient cases to ensure proper processing and scheduling.
• Submit treatment orders to utilization review for approval and follow up to obtain authorization.
• Schedule patient appointments and workers' comp exams.
• Maintain knowledge of prior authorization requirements for efficiency.
• Collaborate with team on special projects as directed by supervisor.
• Follow directions from department lead, manager, and physicians.
• Support other areas in referrals/authorizations as staffing requires.
• Participate in monthly/quarterly department meetings to discuss policies and best practices.
• Adhere to healthcare laws and policies; protect patient confidentiality; complete compliance training.

Skills

Customer service

Data entry

Communication

Multitasking

Education

High School Diploma or equivalent

Tools

Microsoft Excel

Microsoft Word

Job description

TSAOG Orthopaedics & Spine is seeking a Professional Reimbursement Specialist for Workers' Compensation. The role focuses on managing incoming calls, referrals, and documentation to ensure proper processing and scheduling of patient cases.

The ideal candidate will have strong customer service, data entry accuracy, and proficiency with Microsoft Office. The position requires adherence to healthcare regulations and confidentiality, with opportunities to contribute to process improvements.