Workers' Comp Case Manager & Authorization Specialist

Altivera Medical; Denver (CO); On-site; USD 65,000 - 90,000; Full time

Job summary

Altivera Medical seeks a seasoned Workers' Compensation Coordinator to manage a caseload from intake to closure, coordinating authorizations, benefit verifications, and follow-up with providers, patients, and payers to ensure accurate documentation and timely communication.

Ideal candidates have WC claims experience, HIPAA compliance, and reimbursement workflows, with strong organizational and interpersonal skills to navigate complex cases and collaborate across teams.

Qualifications

• Experience with Workers' Compensation claims and regulatory requirements.
• Strong understanding of insurance reimbursement and DME operations.
• Excellent written and verbal communication and stakeholder management.

Responsibilities

• Build and maintain relationships with providers, clinics, injured patients, insurance adjusters, nurse case managers, TPAs, and internal teams.
• Coordinate DME and Workers' Compensation authorizations, including verification of benefits and eligibility, prior authorization, and payer follow-up.
• Manage assigned WC cases from referral through resolution, including intake, authorization, fulfillment, follow-up, reimbursement support, and closure.
• Educate patients regarding equipment, documentation, insurance, financial responsibility, and communication expectations.
• Maintain knowledge of WC statutes, fee schedules, billing requirements, documentation standards, CMS, HIPAA, and Medicare Secondary Payer requirements.
• Escalate issues and collaborate with Territory Managers, Sales, Order Entry, and other teams to remove barriers.
• Maintain accurate case documentation and provide timely updates to stakeholders throughout the lifecycle.

Skills

Workers' Comp claims

Nurse case management

HIPAA compliance

Prior authorization

Revenue cycle

Communication skills

Relationship management

Organization & time management

Problem solving

Medical terminology

Education

Bachelor's degree in Healthcare Administration

Job description

Altivera Medical seeks a seasoned Workers' Compensation Coordinator to manage a caseload from intake to closure, coordinating authorizations, benefit verifications, and follow-up with providers, patients, and payers to ensure accurate documentation and timely communication.

Ideal candidates have WC claims experience, HIPAA compliance, and reimbursement workflows, with strong organizational and interpersonal skills to navigate complex cases and collaborate across teams.