Workers’ Comp Authorization Specialist

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

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.