Workers' Compensation Specialist

Semmes Murphey Clinic; Memphis (TN); On-site; USD 42,000 - 54,000; Full time

Job summary

Semmes Murphey Clinic in Memphis, TN is seeking a Workers’ Compensation Specialist to join our team. The onsite role focuses on obtaining financial medical clearance for patient treatment from workers’ compensation carriers and coordinating with clinical staff to ensure timely care.

You will handle precertification, communicate with insurance adjusters, and maintain patient records while upholding HIPAA standards.

Qualifications

• High school diploma or equivalent.
• Approximately 1 year of precertification experience in workers’ compensation.

Responsibilities

• Obtain intake data and precertification for evaluations and tests.
• Coordinate with workers’ comp carriers and nurse case managers.
• Act as liaison between clinical staff and claims adjusters.
• Coordinate with insurance and billing, nursing, and physicians.
• Maintain patient clearance records and confidentiality per HIPAA.
• Prioritize workflow and manage deadlines.

Skills

Communication skills

Customer service

Attention to detail

Workflow management

HIPAA knowledge

Education

High school diploma or equivalent

Tools

Microsoft Office

EMR

Job description

Description

Semmes Murphey Clinic's mission is to deliver the best care for people suffering from neurological illness while advancing the field of neuroscience.

Job Type

Full-time

The Workers’ Compensation Specialist will work with other members of Semmes Murphey Clinic to provide patient services and is expected to participate in the appropriate team activities with the objective of providing a high standard of patient and clinical service. This position is responsible for obtaining financial medical clearance for patient treatment from various workers’ compensation companies.

Hours

This role is an onsite position with hours of 8:00 am to 4:30 pm, Monday to Friday.

Key Responsibilities

• Obtain necessary intake information, authorization for initial evaluations and follow-up visits; precertification of diagnostic and radiographic tests, surgeries and other procedures
• Communicate with insurance carrier claim adjusters and nurse case managers via telephone, email and fax
• Act as a liaison between the clinical staff and the work comp claims adjustor/nurse case manager
• Communicate and work closely with insurance and billing, nursing and physician staff
• Maintain patient account information by obtaining, recording and updating medical treatment clearance
• Maintain confidentiality; adhere to all HIPAA guidelines/regulations

Requirements

Minimum Requirements

• High school diploma or equivalent
• One (1) year relevant work experience that includes precertification in workers’ compensation

We Are Looking For Someone Who Is/has

• General knowledge of Workers’ Compensation and HIPAA regulations
• Proficient in Microsoft Office (Excel, Outlook, Word)
• Effective communication, both oral and written
• Excellent organizational skills with attention to detail
• Proficient knowledge of insurance requirements and medical/clinical terminology
• Knowledge of internet software and electronic medical records (EMR)
• Ability to provide excellent customer service during difficult or emotional situations
• Ability to manage workflow and prioritize demands

Equal Opportunity Employer/Veterans/Disabled #SMC