Workers Compensation Coordinator

OrthoConnecticut; Pine Rock Park (CT); On-site; USD 26,000 - 33,000; Full time

Job summary

OrthoConnecticut seeks a Workers' Compensation Coordinator to streamline communication among providers, insurers, adjusters, and patients. You will verify claim acceptance, authorize treatments, and coordinate referrals to support patient care and billing operations.

The ideal candidate is organized, detail-oriented, and customer-service focused, with HIPAA compliance and professional communication in a fast-paced healthcare setting.

Qualifications

• Knowledge of workers' compensation processes and workflows.
• Familiarity with medical terminology and orthopedic workflows is a plus.
• Strong written and verbal communication skills.
• Ability to maintain accurate records and documentation.
• Multitask, prioritize, and meet deadlines in a busy healthcare setting.
• Proficiency with email, practice management systems, EMR, and word processing.

Responsibilities

• Verify workers' compensation claim acceptance and obtain treatment authorizations.
• Process authorizations for procedures, pre-op and post-op care.
• Coordinate referrals from urgent care centers and referring facilities.
• Serve as liaison among providers, carriers, adjusters, and patients.
• Respond to requests for information and clarify treatment plans.
• Maintain patient accounts and claim details for billing and reimbursement.
• Follow up on pending authorizations and status inquiries.
• Uphold HIPAA confidentiality and organizational policies.

Skills

Workers' compensation knowledge

Customer service

Communication skills

Organizational skills

Education

High school diploma

College/trade school preferred

Job description

• Base Pay $19.00 - $24.00 / Hour
• Employee Type Non-Exempt - FT

Description

General Statement of Duties

The Workers' Compensation Coordinator facilitates communication and workflow among OrthoConnecticut providers, workers compensation insurance carriers, adjusters, nurse case managers, patients, employers, and referring facilities. This position is responsible for verifying workers compensation claim acceptance, obtaining treatment authorizations, coordinating appointments and referrals, responding to requests regarding treatment and work capacity, and maintaining accurate information to support patient care and billing operations.

The ideal candidate is organized, detail-oriented, and customer-service-focused, with the ability to manage multiple responsibilities while maintaining professionalism, confidentiality, and effective communication in a fast-paced healthcare environment.

Primary Responsibilities and Functions

The Workers Compensation Coordinator will perform the following duties, including but not limited to:

Verify workers compensation claim acceptance and obtain authorization for treatment, procedures, consultations, and office visits as needed.

Process authorization requests for surgical procedures, pre-operative appointments, and post-operative care.

Serve as a liaison among OrthoConnecticut providers, workers compensation insurance carriers, adjusters, nurse case managers, patients, employers, and referring facilities.

Respond to requests for additional information or clarification regarding treatment plans, medical documentation, and patients’ work status or work capacity.

Review medical notes and work-status documentation for accuracy and provide requested records to insurance carriers and other authorized parties.

Establish and maintain positive working relationships with insurance carrier representatives, adjusters, nurse case managers, employers, and referring facilities.

Coordinate referrals received from urgent care centers, occupational health facilities, and other referring providers.

Schedule patient appointments and coordinate related workers compensation services to support continuity of care.

Communicate appointment details, authorization requirements, and relevant updates to appropriate parties.

Maintain accurate patient account information and workers compensation claim details to support appropriate billing and reimbursement.

Follow up on pending authorizations, claim status inquiries, and outstanding documentation to minimize delays in patient care.

Maintain patient confidentiality and comply with HIPAA requirements, applicable regulations, and OrthoConnecticut policies and procedures.

Maintain working knowledge of practice management systems, electronic medical records, and other software necessary to perform job responsibilities.

Attend staff meetings, training sessions, and continuing education activities as requested.

Perform additional duties as assigned by the Workers Compensation Supervisor.

Supervisory Responsibilities

This position has no supervisory responsibilities.

Required Knowledge, Skills, and Abilities

Knowledge of workers compensation processes, protocols, and administrative workflows.

Familiarity with basic medical terminology; orthopedic terminology and clinical workflows preferred.

Strong customer service, written communication, and verbal communication skills.

Ability to communicate professionally and effectively with patients, employers, providers, insurance carriers, adjusters, nurse case managers, and referring facilities.

Strong organizational skills and attention to detail, with the ability to maintain accurate records and documentation.

Ability to multitask, prioritize competing responsibilities, and meet deadlines in a busy, fast-paced healthcare environment.

Ability to resolve routine inquiries professionally and esc‑alate issues when appropriate.

Proficiency with email, internet applications, practice management systems, electronic medical records, and word processing software.

Ability to maintain patient confidentiality and handle sensitive medical and claim-related information in accordance with HIPAA and organizational policies.

Ability to work independently while contributing effectively to a collaborative team environment.

Professionalism, reliability, adaptability, and a commitment to providing excellent customer service.

Acceptable Experience and Training

High school diploma or equivalent required.

College education or trade school training preferred.

Customer service experience required.

A minimum of eighteen (18) months of experience working in a physician’s office or hospital setting preferred.

Previous experience in workers compensation administration or an orthopedic practice preferred.

Experience coordinating appointments, processing authorizations, managing medical documentation, or communicating with insurance carriers preferred.

Professional Expectations

The Workers Compensation Coordinator is expected to demonstrate professionalism, dependability, organization, and a commitment to excellent service. The individual must be able to manage multiple requests, communicate effectively with internal and external stakeholders, and support timely coordination of workers compensation cases while maintaining the accuracy and confidentiality of patient information.

All duties must be performed in accordance with applicable laws and regulations, organizational policies, established procedures, and the requirements of the Workers Compensation Supervisor.

OrthoConnecticut, delivering exceptional care and real results has always been our mission, though we did things a little differently when we opened our doors in 1954. Today, we provide orthopedic care in a new state-of-the-art Musculoskeletal Center of Excellence, in which we provide the full spectrum of high-quality services under one roof. Now we can diagnose and treat the complete range of musculoskeletal issues for all ages in one easily accessible location with minimal wait time and a more efficient patient experience. One thing that hasn't changed since in 1954: our commitment to you

OrthoConnecticut is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.