Workers' Compensation Specialist

Clinic; Memphis (TN); On-site; USD 42,000 - 52,000; Full time

Job summary

Semmes Murphey Clinic seeks a Workers’ Compensation Specialist to obtain medical clearance and precertification for patient treatments. The role requires coordination with insurance carriers, nurse case managers, and clinical staff to ensure timely, compliant processing.

The onsite position operates Monday–Friday, 8:00 am–4:30 pm, with a focus on accurate data entry, HIPAA compliance, and effective communication with payers and care teams to support high-quality patient services.

Qualifications

• High school diploma or equivalent.
• 1 year of relevant work experience with precertification in workers’ compensation.
• 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).

Responsibilities

• Obtain intake information and precertification for evaluations, tests, surgeries and other procedures.
• Communicate with insurance claim adjusters and nurse case managers by phone, email and fax.
• Serve as liaison between clinical staff and work comp claims adjustor/nurse case manager.
• Collaborate with insurance, billing, nursing and physician staff.
• Maintain patient account information for medical clearance.
• Maintain confidentiality and HIPAA compliance.

Skills

Communication skills

Organizational skills

Customer service

Attention to detail

HIPAA knowledge

EMR systems

Education

High school diploma

Tools

Microsoft Office

EMR software

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.

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.

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