Workers’ Comp Claims & Compliance Coordinator

Glenwood-Medical-Associates,-P; Glenwood Springs (CO); On-site; USD 55,000 - 72,000; Full time

Job summary

Glenwood Medical Associates is seeking a Worker's Compensation Coordinator to manage all aspects of workers’ compensation claims within the medical practice. This role serves as a liaison among injured workers, employers, carriers, adjusters, case managers, and healthcare providers to ensure timely authorization, accurate billing, compliance with state regulations, and efficient claim resolution.

Responsibilities include verifying coverage, documenting parties’ details, securing treatment

Qualifications

• Previous medical office experience and knowledge of debits and credits preferred.
• Knowledge of CPT and ICD-10 coding a plus.
• Must have basic computer skills and some collection experience.
• Must be able to establish priorities, meet deadlines, work well under pressure.
• Must be a team player.

Responsibilities

• Verify workers’ compensation insurance coverage and claim information.
• Obtain and document employer, insurance carrier, and adjuster information.
• Secure treatment authorizations and referrals as required.
• Schedule and coordinate appointments for injured workers.
• Maintain accurate workers’ compensation records within the EMR system.
• Communicate with employers, adjusters, nurse case managers, attorneys, and patients regarding claim status and treatment plans.
• Review medical documentation for completeness and compliance with workers’ compensation requirements.
• Process and submit workers’ compensation billing and supporting documentation.
• Monitor accounts receivable and follow up on unpaid or denied claims.
• Research and resolve billing discrepancies, denials, and reimbursement issues.
• Ensure compliance with state workers’ compensation regulations and payer guidelines.
• Track physician reports, work status forms, and return-to-work documentation.
• Prepare reports and provide updates to management regarding claim activity and reimbursement trends.
• Assist providers and clinical staff with workers’ compensation procedures and documentation requirements.
• Maintain confidentiality of patient and claim information in accordance with HIPAA regulations.
• Assists with the training of other PFS staff
• Attends educational classes when necessary to enhance knowledge base
• Other duties as assigned by PFS Supervisor or Manager
• Must be able to travel between offices as requested.

Skills

Communication

Team player

Attention to detail

HIPAA compliance

Travel readiness

Tools

EMR system

Billing software

Job description

Glenwood Medical Associates is seeking a Worker's Compensation Coordinator to manage all aspects of workers’ compensation claims within the medical practice. This role serves as a liaison among injured workers, employers, carriers, adjusters, case managers, and healthcare providers to ensure timely authorization, accurate billing, compliance with state regulations, and efficient claim resolution.

Responsibilities include verifying coverage, documenting parties’ details, securing treatment