Workers’ Compensation Coordinator

Saint Francis Hospital Muskogee, Inc.; Warren (MI); On-site; USD 45,000 - 60,000; Full time

Job summary

Saint Francis Hospital Muskogee, Inc. is seeking a Workers' Compensation Coordinator to manage pre-visit W/C cases, acting as a liaison among patients, providers, employers, and case managers to ensure timely authorizations and scheduling.

The role emphasizes meticulous documentation and HIPAA compliance. The position requires a high school diploma or GED (associate's degree preferred) and at least two years of related experience in case management, medical billing, or workers' compensation

Qualifications

• Minimum education: High school diploma or GED. Associate's degree preferred.
• Knowledge of worker's compensation processes and claims.
• Experience in case management, medical billing, or worker's compensation coordination.

Responsibilities

• Coordinates workers' compensation cases from initial referral through pre-visit services.
• Schedules first appointments and assists patients with follow-up coordination.
• Obtains and verifies workers' compensation insurance information and claim details.
• Communicates with adjusters, nurse case managers, employers, and providers to secure authorizations and approvals.
• Maintains accurate case information in the EMR and ensures timely documentation.

Skills

Microsoft 365

Organizational skills

Effective communication

Attention to detail

Problem solving

Education

High school diploma or GED

Associate's degree (preferred)

Tools

EMR systems

Medical scheduling software

Medical billing coordination

Job description

This position is ECB status - requires a minimum number of worked hours per month as needed by the department; limited benefit offerings.

Days

Job Summary: The Workers' Compensation Coordinator is responsible for coordinating all aspects of pre-visit worker's compensation cases for patients within the practice. This role serves as a liaison between patients, providers, employers, worker's compensation case managers, and providers to ensure timely authorization, scheduling, documentation, and claim processing.

Minimum Education: High school diploma or GED. Associate's degree, preferred.

Licensure, Registration and/or Certification: None.

Work Experience: Minimum 2 years experience in case management, medical billing, medical office administration, or worker's compensation coordination.

Knowledge, Skills, and Abilities: Knowledge of Microsoft 365 and other applicable software. Knowledge of worker's compensation processes, insurance verification, authorizations, and medical terminology. Sound knowledge of third-party billing coordination and claims processing. Knowledge of Electronic Medical Record (EMR) systems and medical scheduling software. Strong organizational skills with the ability to manage multiple cases and deadlines simultaneously. Effective interpersonal skills. Excellent communication skills, both written and verbal that present clear and concise information. Detail-oriented with strong problem-solving and follow-up abilities.

Essential Functions and Responsibilities: Coordinates worker's compensation cases from initial referral through pre-visit services. Schedules first appointments and assists patients with follow-up appointment coordination. Obtains and verifies worker's compensation insurance information, claim details, and employer information. Communicates with worker's compensation adjusters, nurse case managers, employers, and providers. Secures authorizations and approvals for evaluations, treatments, procedures, imaging, and therapy. Requests, tracks, and distributes medical records, work status reports, physician notes, and other required documentation for pre-visit approval. Ensures providers complete all required worker's compensation forms and reports accurately and promptly. Maintains accurate and up-to-date case information within the electronic medical record (EMR) system. Follows up on missing information, denied authorizations, or outstanding documentation requests for pre-visit preparation. Maintains confidentiality and compliance with the Health Insurance Portability and Accountability Act (HIPAA) and worker's compensation regulations.

Decision Making: Independent judgment in planning sequence of operations and making minor decisions in a complex technical or professional field.

Working Relationships: Works directly with patients and/or customers. Works with internal and/or external customers via telephone or face to face interaction. Works with other healthcare professionals and staff. Works frequently with individuals at Director level or above.

Special Job Dimensions: None.

Supplemental Information: This document generally describes the essential functions of the job and the physical demands required to perform the job.This compilation of essential functions and physical demands is not all inclusive nor does it prohibit the assignment of additional duties.

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