Workers Comp Coordinator - Sharp TriCity - Day Shift - Full Time

Sharp HealthCare; Oceanside (CA); On-site; USD 34,000 - 43,000; Full time

Job summary

Sharp HealthCare in Oceanside, CA is seeking a Worker's Compensation Coordinator to schedule appointments, complete registrations in the practice management system, and submit authorizations for orthopedic care. The role involves acting as a liaison between adjusters, employers and physician teams to prepare patients for visits and ensure accurate data entry.

The candidate will manage patient portal access, handle forms and maintain confidentiality while supporting billing and claims processes.

Qualifications

• Strong background in customer service.
• Competencies in leadership, teamwork and cooperation.
• Strong ethics and a high degree of personal and professional integrity.
• An effective communicator at all levels in the organization, with strong oral, written and persuasive skills.

Responsibilities

• Schedule new and existing appointments and register patients in the practice management system.
• Submit authorizations and coordinate with adjusters, employers and physician teams.
• Prepare patients for physician, MRI or Physical Therapy visits and ensure forms are completed prior to visits.
• Enter basic demographics, email, Social Security, insurance and financial data into the system while protecting privacy.
• Maintain patient portal access and ensure HIPAA compliance.

Skills

Customer service

Leadership

Teamwork

Communication

Education

Bachelor's Degree

Job description

Hours:

Shift Start Time: 8 AM

Shift End Time: 4:30 PM

AWS Hours Requirement: 8/40 - 8 Hour Shift

Weekend Requirements: No Weekends

On-Call Required: No

Hourly Pay Range (Minimum - Midpoint - Maximum): $25.000 - $26.320 - $31.160

The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices.

What You Will Do

The Worker's Compensation Coordinator works with Worker's Compensation patients; schedules new and existing appointments, completes registration in the practice management system, submits authorizations, functions as a liaison for patients between adjusters, employers and physician teams. The Worker's Compensation Coordinator will work with the practice patients, clinical teams and business office on accurately preparing the patient for their physician, MRI or Physical Therapy visit. This position takes incoming calls, enters basic demographics; email, social security, insurance, and financial data into the Practice Management System. The Worker's Compensation Coordinator will ensure that the patient has access to the patient portal, sends all forms and receives completed forms prior to the patient visit. They will ensure that patient satisfaction goals are met or exceeded.

Required Qualifications

• H.S. Diploma or Equivalent
• 1 Year year of experience in health care.
• 2 Years of billing and claims experience.

Preferred Qualifications

• Bachelor's Degree
• Worker's Compensation authorization and claims processing experience.

Essential Functions

• The position characteristics reflect the most important duties, responsibilities and competencies considered necessary to perform the essential functions of the job in a fully competent manner. They should not be considered as a detailed description of all the work requirements of the position. The characteristics of the position and standards of performance may be changed by TCMC with or without prior notice based on the needs of the organization.
  Maintains a safe, clean working environment, including unit based safety and infection control requirements.
  Prepares medical charts and records for patient visits
  Reviews specific protocols requested by client and advise specialty physician accordingly
  Obtain authorizations from clients and insurance carrier for orthopedic treatment as prescribed by physicians. Report denials or delays to operations manager
  Obtain authorizations for patient referrals to specialists, diagnostic testing and surgeries
  Advise physician in authorization request is denied
  Maintain records of all referrals
  Makes appointments for patients with specialists
  Contacts patients who miss an appointment and/or report missed appointment to employer
  Processes and mails or faxes reports to employers and insurance carriers
  Mails or faxes status update reports
  Tracks receipt of transcription reports. Reviews reports and files in orthopedic chart. Distributes copy of report to referring physician who will initial and return the report. Files report in patient’s medical chart. Mails reports to employers and insurance carriers
  Files final copy of authorized referrals in patient file for physician review
  Utilizes formal channels of communications to report concerns, personal requests and patient issues
  Respects patient’s right to privacy and confidentiality
  Understands and follows department’s organizational policies and procedures
  Assists billing office with claims processing
  Performs other related duties as requested
  Ensures that patient confidentiality is always protected, both audible and visible.
  HIPAA Notice of Privacy Practices is on display and given to all new patients and then every three years.
  Ensure compliance with all medical practice regulations, such as, but not limited to HIPAA and OSHA.

Knowledge, Skills, and Abilities

• Strong background in customer service.
• Competencies in the areas of leadership, teamwork and cooperation.
• Strong ethics and a high degree of personal and professional integrity.
• An effective communicator at all levels in the organization, with strong oral, written and persuasive skills.

Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class