Workers' Compensation Coordinator

Summit Health; New Jersey; On-site; USD 28,000 - 32,000; Full time

Job summary

VillageMD is seeking a Workers’ Compensation Coordinator to schedule WC appointments and coordinate referrals between CityMD and Summit Health. The role requires authorizations, pre-visit intake verification and proactive communication with payers, employers, and patients.

The candidate will build Athena charts, maintain case policy accuracy, and ensure timely scheduling while upholding HIPAA and workflow standards.

Qualifications

• Bachelor’s Degree in Public Health, Business, Hospitality Management or other applicable degree preferred.
• Experience with Patient Scheduling preferred.
• Experience working in a Call Center preferred.
• Experience managing Workers’ Compensation appointments and patients.
• Experience working with payer contacts (nurse case managers, adjusters, etc.).
• Computer: Microsoft Office (Excel), CRM (Salesforce), Outpatient scheduling system (i.e., Athena, Epic, Referwell).
• High attention to detail and strong communication skills.

Responsibilities

• Schedule Workers’ Compensation appointments in a timely manner.
• Obtain initial authorizations to treat and pre-authorizations before scheduling.
• Build patient Athena chart and link to the appointment with policy details.
• Verify required Workers’ Compensation intake forms are completed pre-visit.
• Communicate with patients and payer contacts professionally by phone and email.
• Engage with employers, adjusters and nurse case managers regarding referrals and scheduling.
• Manage inbound/outbound calls and emails from employers, adjusters, and patients.
• Review cancelled appointments and facilitate rescheduling.
• Collaborate with other Summit Health and CityMD departments to ensure smooth workflows.
• Leverage Salesforce and Referwell for referral coordination and tracking.

Skills

Experience with patient scheduling

Experience working in a call center

Experience managing workers’ comp

Bilingual in Spanish a plus

Education

Bachelor’s degree in Public Health, Business, Hospitality Management or other applicable degree

Tools

Salesforce

Athena

Epic

Referwell

Job description

About Our Company

We’re a physician-led, patient-centric network committed to simplifying health care and bringing a more connected kind of care.

Our primary, multispecialty, and urgent care providers serve millions of patients in traditional practices, patients' homes and virtually through VillageMD and our operating companies Village Medical, Village Medical at Home, Summit Health, CityMD, and Starling Physicians.

When you join our team, you become part of a compassionate community of people who work hard every day to make health care better for all. We are innovating value-based care and leveraging integrated applications, population insights and staffing expertise to ensure all patients have access to high-quality, connected care services that provide better outcomes at a reduced total cost of care.

Please Note: We will only contact candidates regarding your applications from one of the following domains: @summithealth.com, @citymd.net, @villagemd.com, @villagemedical.com, @westmedgroup.com, @starlingphysicians.com, or @bmctotalcare.com.

Job Description

The Workers’ Compensation Coordinator is responsible for the scheduling of all Summit Health Workers’ Compensation appointments, in addition to the coordination of referrals, whether from CityMD to Summit Health or Summit Health to Summit Health. The individual will be expected to collaborate with payers (adjusters, nurse case managers, claims examiners), employers and patients to obtain initial authorizations to treat, verify pre-visit intake information, and obtain pre-authorizations.

• Schedule Workers’ Compensation appointments in a timely manner, whether from CityMD referral or external payers/patients.
• Obtain initial authorizations to treat and pre-authorizations for advanced treatment orders from payer contacts (nurse case managers, adjusters, etc.) before scheduling.
• Build patient Athena chart and register accordingly by ensuring Workers’ Comp Case Policy is up-to-date with claim information and authorization details, and linked to the appointment
• Verify required Workers’ Compensation intake forms are completed by the patient pre-visit; engage with patient if forms are not completed; make updates in Athena where necessary.
• Communicate with patients and payer contacts, via phone and email, in a professional and courteous fashion when needed to discuss Workers’ Compensation information, patient preferences, appointment coordination, etc.
• Conduct outbound calls to employers, adjusters and nurse case managers regarding CityMD referrals ordered, Workers’ Compensation information needed, appointment scheduling, etc.
• Assist and manage inbound calls and emails from employers, adjusters, nurse case managers and patients regarding Workers’ Compensation referrals and appointments.
• Review cancelled Workers’ Compensation appointments, communicating any appointment changes to the adjuster/nurse case manager, and facilitate rescheduling the patient.
• Engage with Summit Health offices directly who have scheduled appointments on their own and do not comply with centralized Workers’ Compensation workflows/resources.
• Leverage CRM Salesforce to reference client (employer and payer) referral coordination needs and special instructions.
• Utilize Referwell referral management technology to determine the most appropriate provider for scheduling a referral.
• Track all activities and progress of referral cases and appointments scheduled (outreaches, referral status, appointment scheduling progress, etc.)
• Daily extensive computer use navigating multiple applications while engaging in conversations with payer contacts, employers, patients or clinical office staff.
• Follow all HIPAA and any other governmental or state agency requirements regarding the appropriate handling of PHI documents to patients, employers, payers and providers.
• Must adhere to the call center schedule while being accountable to follow specific call quality guidelines and measurements.
• Demonstrate exemplary customer service skills.
• Work closely with other departments including but not limited to Workers’ Compensation Case Management, UC Referral Management, Aftercare, Medical Records, Compliance, and Revenue Cycle with the goal of ensuring that Summit Health-CityMD is providing high quality and appropriate care to all work-related injury patients and ensuring seamless operation processes for customer experience.
• Collaborate with Sales, Employer Concierge Services and Operations Teams to resolve issues and ensure the highest level of customer satisfaction.
• Other relevant duties as assigned.

Qualifications

A candidate’s qualifications will include:

• Bachelor’s Degree in Public Health, Business, Hospitality Management or other applicable degree preferred
• Experience with Patient Scheduling preferred
• Experience working in a Call Center preferred
• Experience managing Workers’ Compensation appointments and patients
• Experience working with payer contacts (nurse case managers, adjusters, etc.)
• Computer: Microsoft Office (Excel), CRM (Salesforce), Outpatient scheduling system (i.e., Athena, Epic, Referwell)
• High attention to detail
• Exceptional interpersonal and communication skills (verbal and written)
• Positive attitude and ability to project this around others
• Ability to work in a fast-paced, ever-changing environment
• Workers well independently and in a team environment
• Bilingual in Spanish a plus
• Must exhibit passion for outstanding results and compassion for those we work with and serve Additional Information

The Workers’ Compensation Coordinator will report directly to the Senior Manager, Employer Concierge Services who may modify these responsibilities and activities to suit the needs of the goals behind the Workers’ Compensation program.

This is a non exempt position with the salary range of $20.00 - $23.00/hour based on experience.

Pay Range: $15.10 - $18.37 Hourly

The provided compensation range is based on industry standards and salary determinations will be made based on numerous factors including but not limited to years of experience and location of position.

About Our Commitment

Total Rewards at VillageMD

Our team members are essential to our mission to reshape healthcare through the power of connection. VillageMD highly values the critical role that health and wellness play in the lives of our team members and their families. Participation in VillageMD’s benefit platform includes Medical, Dental, Life, Disability, Vision, FSA coverages and a 401k savings plan.

Equal Opportunity Employer

Our Company provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to, and does not discriminate on the basis of, race, color, religion, creed, gender/sex, sexual orientation, gender identity and expression (including transgender status), national origin, ancestry, citizenship status, age, disability, genetic information, marital status, pregnancy, military status, veteran status, or any other characteristic protected by applicable federal, state, and local laws.