Workers' Comp Authorization Coordinator

University Orthopedics; Mansfield (MA); On-site; USD 42,000 - 54,000; Full time

Job summary

University Orthopedics is seeking a Workers’ Compensation Authorization Coordinator to obtain pre-authorization for all diagnostic tests and surgical requests, ensuring timely access to care for patients under workers’ compensation guidelines.

You will build strong relationships with case managers, adjusters, and providers while handling case documentation, demographics, insurance information, and utilization review processes across Massachusetts and Rhode Island.

Qualifications

• High School education or equivalent is required.
• 2-3 years of relevant work experience in a medical office or workers' compensation setting.
• 1+ year obtaining prior authorizations; orthopedic office experience preferred.
• Must be able to travel to all sites when necessary.

Responsibilities

• Develop and maintain positive working relationships with case managers, adjusters, employers, vendors.
• Obtain pre-authorization for all diagnostics, and surgical requests.
• Understand the process and work with Utilization Review.
• Phone triage per scenario, document patient questions, consult with medical providers, and verify patient demographics and insurance information.
• Understand & apply workers’ compensation jurisdiction laws and regulations for Mass & RI.
• Additional duties as assigned by the Manager to meet department needs.

Skills

Oral and written communication

Self-directed

Work independently

Customer service

Education

High School diploma or equivalent

Tools

Excel

Word processing

Job description

Job Title: Workers’ Compensation Authorization Coordinator

Reports to: Workers’ Compensation Manager

GENERAL SUMMARY OF DUTIES:

The Workers’ Compensation Authorization Coordinator is responsible for obtaining pre-authorization for all diagnostics testing and surgical requests.

Essential Job Functions

• Develop and maintain positive working relationships with case managers, adjusters, employers, vendors.
• Obtain pre-authorization for all diagnostics, and surgical requests.
• Understanding the process and working with Utilization Review.
• Phone triage per scenario, document patient questions, consult with medical providers for appropriate and thorough documentation, and return patient phone calls in a timely manner along with verifying patient demographics and insurance information.
• Understand & apply workers’ compensation jurisdiction laws and regulations for Mass & RI.
• Additional duties as assigned by the Manager to meet department needs.

Requirements

• High School education or equivalent required.
• 2-3 years relevant work experience in a medical office setting or related workers' compensation experience required.
• 1+ year obtaining prior authorizations required, experience supporting an orthopedic office preferred.
• Must be self-directed and able to work with minimal supervision and direction.
• Skills in oral and written communication.
• Knowledge of computer applications for Excel spreadsheets, and word processing.
• Must be able to travel to all sites if/when necessary.