Workers Compensation Specialist

Socket.dev; Fort Worth (TX); On-site; USD 42,000 - 64,000; Full time

Job summary

Socket.dev in Alliance, Texas, is seeking an experienced Workers' Compensation Specialist to serve as a liaison between patient, insurance carrier, and physician in a fast-paced environment.

This onsite role focuses on accurate data collection, insurance verification, pre-certifications, and timely billing, with emphasis on TWCC forms and EPIC workflows.

You will coordinate with clinic staff, manage appointments, and protect patient confidentiality while supporting billing operations.

Qualifications

• High School Diploma or GED, required.
• Worker's Comp experience in a clinical setting strongly preferred.
• Referral Intake experience in an ortho setting preferred.
• Graduate of accredited Medical Administration program preferred.
• Knowledge of TWCC rulings and forms strongly preferred.
• Ability to read, understand and master policies and regulations.
• Ability to use patient management systems and computer software (e.g., patient billing & collecting system, electronic medical record system, word processing).
• Ability to interact and communicate well with patients, staff, and vendors.
• Worker's Comp experience and EPIC experience is a PLUS!!!

Responsibilities

• Obtains complete and accurate patient and injury information before scheduling appointments.
• Verifies work-related injury information with employer personnel.
• Verifies eligibility of injury and insurance benefits with insurance carrier representative.
• Translates between provider and patient as needed.
• Obtains correct insurance carrier billing address and claim number if assigned.
• Ensures proper documentation is attached to billing claims before submission or re-submission of the claims.
• Enters complete and accurate demographics into the billing system to ensure proper billing before the patient's first visit.
• Obtains pre-certifications and authorizations for treatment on a daily basis.
• Ensures completion of all TWCC required forms.
• Performs various collection activities to ensure payment is received and posted for each account.
• Interprets appointment request and schedules patient appointment based on clinic policies.
• Checks answering service & reminder call email each morning for patient messages.
• Obtains patient's demographic information, insurance policy and medical issue.
• Informs patient about new patient and payment policies & referrals.
• Verifies insurance for same day add-on appointments.
• Relays relevant information to the Clinic Front Desk, Medical Records and appropriate internal staff when adding or changing an appointment.
• Provides any special needs of the patient to the Physician.
• Answers telephone, screens calls, takes messages, transfers calls to the appropriate area and provides information to keep the patient and clinic staff fully advised regarding appointments scheduled.
• Answers questions regarding patient appointments as requested.
• Makes necessary patient and/or policyholder information corrections in the Appointment System as necessary and advises the Patient and Billing.
• Safeguards patient information and ensures all information remains confidential.
• Request assistance from the Biller or Collectors for difficult account billing questions.
• Participates in office meetings and educational activities.
• Maintains work area in neat and orderly manner.

Skills

Patient communication

Billing & collections

Insurance verification

Data entry

Medical terminology

Education

High School Diploma or GED

Tools

EPIC

EMR system

Billing software

Job description

Job Summary: We are seeking an experienced Workers' Compensation Specialist to work in our Alliance location. The Workers' Compensation Specialist is the liaison between the patient, insurance carrier, and physician and works in a fast-paced position.

Onsite role

Key Functions:

• Obtains complete and accurate patient and injury information before scheduling appointments. Creates and maintains a Medical Chart on all workers comp patients.
• Verifies work related injury information with proper employer personnel.
• Verifies eligibility of injury and insurance benefits with insurance carrier representative.
• Translates between provider and patient as needed.
• Obtains correct insurance carrier billing address and claim number if assigned.
• Ensures proper documentation is attached to billing claims before submission or re- submission of the claims.
• Enters complete and accurate demographics into the billing system to ensure proper billing before the patient's first visit.
• Obtains pre-certifications and authorizations for treatment on a daily basis.
• Ensures completion of all TWCC required forms.
• Performs various collection activities to ensure payment is received and posted for each account. Contacts carriers, patients, or employers as needed to obtain/provide account information.
• Interprets appointment request and schedules patient appointment based on clinic policies. Identifies any problems with making the appointment and advises Physician and/or Manager.
• Checks answering service & reminder call email each morning for patient messages.
• Obtains patient's demographic information, insurance policy and medical issue.
• Informs patient about new patient and payment policies & referrals.
• Verifies insurance for same day add-on appointments.
• Relays relevant information to the Clinic Front Desk, Medical Records and appropriate internal staff when adding or changing an appointment.
• Provides any special needs of the patient to the Physician.
• Answers telephone, screens calls, takes messages, transfers calls to the appropriate area and provides information to keep the patient and clinic staff fully advised regarding appointments scheduled.
• Answers questions regarding patient appointments as requested.
• Makes necessary patient and/or policyholder information corrections in the Appointment System as necessary and advises the Patient and Billing.
• Safeguards patient information and ensures all information remains confidential.
• Request assistance from the Biller or Collectors for difficult account billing questions.
• Participates in office meetings and educational activities.
• Maintains work area in neat and orderly manner.

#AO

Requirements

• High School Diploma or GED, required.
• Must have Worker's Comp experience in a clinical setting-Strongly Preferred
• Referral Intake experience in an ortho setting preferred.
• Graduate of accredited program in Medical Administration, preferred.
• Knowledge of TWCC rulings and forms strongly preferred.
• Ability to read, understand and master policies and regulations.
• Ability to use patient management systems and computer software (e.g., patient billing & collecting system, electronic medical record system, word processing).
• Ability to interact and communicate well with patients, staff, and vendors.

Requirements

Worker's Comp experience and EPIC experience is a PLUS!!!