Workers' Comp Referrals Specialist

Laorthospec; Lafayette, Northern (LA, KY); Hybrid; USD 36,000 - 48,000; Full time

Job summary

Paylocity is seeking a Worker’s Compensation Referral Coordinator to facilitate medical authorizations with workers’ compensation carriers for services rendered to patients with workers’ compensation claims.

The role emphasizes timely scheduling, close collaboration with adjusters and providers, and maintaining patient confidentiality in a fast-paced office setting.

Qualifications

• High school diploma or GED required.
• 1 year experience in appointment scheduling, preferably medical setting.
• Knowledge of workers’ compensation processes advisable.

Responsibilities

• Receive and manage referrals for LOS physicians and initiate approval with workers’ comp.
• Communicate with adjusters, patients, attorneys, and staff to clarify referrals.
• Schedule appointments promptly after referral approval; escalate for acute cases as needed.
• Obtain medical records or provider approval prior to scheduling appointments.

Skills

Appointment scheduling

Customer service

Office software

Multitasking

Education

High school diploma or GED

Tools

Microsoft Excel

Microsoft Word

Outlook

Job description

Description

Job Description: Worker’s Compensation Referral Coordinator

FLSA Status: Non-Exempt

Supervision Received: Business Office Manager

Supervision Exercised: N/A

Position Summary

Responsible for facilitation of medical authorizations by workers’ compensation carriers for services rendered to patients covered under workers’ compensation claims.

Essential Functions:

1. Receive and manage referrals for LOS physicians including initiation of approval by workers compensation agency/third party, patient registration and scheduling patient appointments.

2. Communicates with adjusters, patients, attorneys, physician staff and physicians as well as other work comp staff as needed to clarify referral requests.

3. Maintains goal of scheduling appointments immediately upon receipt of a referral approval. For acute/urgent injuries, get with the work comp team lead and/or appropriate work comp coordinator to determine if we must move forward with scheduling prior to official approval receipt.

4. Obtain appropriate medical records prior to patient appointment or in order to obtain approval from the provider prior to patient scheduling.

5. Assist in maintaining goals for quality patient care, patient satisfaction, and treatment compliance.

6. Assist the workers’ compensation coordinators as needed and per availability.

7. Answer phone and appropriately handle incoming workers’ compensation phone calls.

8. Maintains patient confidentiality.

Requirements

EDUCATION:

High school diploma or GED

EXPERIENCE:

• One-year experience in appointment scheduling, preferably in a medical setting.

REQUIREMENTS:

• Medical office experience. Knowledge of workers compensation processes and guidelines.

KNOWLEDGE:

1. Knowledge of the physician billing processes, 1010A’s and 1009’s.
2. Knowledge of computer systems.
3. Advanced computer knowledge, including Window based programs.

SKILLS:

1. Skill in customer service and an understanding of LOS’ code of conduct.
2. Skill in using computer programs and applications including Microsoft Excel, Microsoft Word and Outlook.
3. Skill in establishing good working relationships with both internal and external customers.

ABILITIES:

1. Ability to multi task in a fast- paced environment. Must be detailed oriented with strong organizational skills.
2. Ability to understand patient demographic information and determine insurance eligibility.
3. Ability to work independently and demonstrate the ability to analyze data.

ENVIRONMENTAL/WORKING CONDITIONS:

• Normal office environment.

PHYSICAL/MENTAL DEMANDS:

• Requires sitting and standing associated with a normal office environment. Some bending and stretching required. Manual dexterity using a calculator and computer keyboard.

This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.