Worker’s Compensation Representative
Louisiana Orthopaedic Specialists, Lafayette, LA, United States
Job Description: Worker’s Compensation Representative
FLSA Status: Non-Exempt
Supervision Received: Business Office Manager
Supervision Exercised: N/A
Position Summary Responsible for facilitation of medical authorizations by workers’ compensation carriers for services rendered to patients covered under workers’ compensation claims.
Qualifications
Experience managing workers’ compensation processes in accordance with carrier authorizations and guidelines.
Proven ability to ensure accurate, compliant, and timely submission of workers’ compensation authorization requests.
Strong knowledge of workers’ compensation regulations, payer requirements, and authorization protocols.
Skilled in coordinating with workers’ compensation carriers, providers, and patients to resolve workers compensation authorization issues.
Effective communicator serving as a liaison between clinical teams and insurance carriers.
Duties and Responsibilities
Prepare requests for treatment to be authorized by workers’ compensation carriers, both state and federal claims, via fax, email, and online.
Correspond with all workers’ compensation adjusters, nurse case managers and attorneys to ensure we get a response and that it’s in accordance with guidelines.
Prepare 1010A’s and 1009’s when necessary and justified.
Keep record of all new patient referrals, patients that do not show up for or cancel their appointments, all requested treatment sent out for approval, and all requested treatment that is denied.
Operate office equipment, such as voice mail messaging systems, facsimile, scanner, and use work processing, spreadsheet, or other applications to prepare reports, invoices, financial statements, letters, case histories, or medical records.
Requirements
Education: High school diploma or GED.
Minimum two to three years of experience in medical billing.
Medical office experience; knowledge of workers’ compensation processes and guidelines.
Knowledge of physician billing processes, 1010A’s and 1009’s, and computer systems.
Advanced computer knowledge, including Windows based programs.
Skill in customer service and understanding of LOS’ code of conduct.
Skill in using computer programs and applications including Microsoft Excel, Microsoft Word, and Outlook.
Skill in establishing good working relationships with both internal and external customers.
Ability to multi-task in a fast-paced environment, be detail oriented with strong organizational skills.
Ability to understand patient demographic information and determine insurance eligibility.
Ability to work independently and analyze data.
Environmental/Working Conditions Normal office environment.
Physical/Mental Demands Requires sitting and standing associated with a normal office environment. Some bending and stretching required. Manual dexterity using a calculator and computer keyboard.
This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.
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Supervision Received: Business Office Manager
Supervision Exercised: N/A
Position Summary Responsible for facilitation of medical authorizations by workers’ compensation carriers for services rendered to patients covered under workers’ compensation claims.
Qualifications
Experience managing workers’ compensation processes in accordance with carrier authorizations and guidelines.
Proven ability to ensure accurate, compliant, and timely submission of workers’ compensation authorization requests.
Strong knowledge of workers’ compensation regulations, payer requirements, and authorization protocols.
Skilled in coordinating with workers’ compensation carriers, providers, and patients to resolve workers compensation authorization issues.
Effective communicator serving as a liaison between clinical teams and insurance carriers.
Duties and Responsibilities
Prepare requests for treatment to be authorized by workers’ compensation carriers, both state and federal claims, via fax, email, and online.
Correspond with all workers’ compensation adjusters, nurse case managers and attorneys to ensure we get a response and that it’s in accordance with guidelines.
Prepare 1010A’s and 1009’s when necessary and justified.
Keep record of all new patient referrals, patients that do not show up for or cancel their appointments, all requested treatment sent out for approval, and all requested treatment that is denied.
Operate office equipment, such as voice mail messaging systems, facsimile, scanner, and use work processing, spreadsheet, or other applications to prepare reports, invoices, financial statements, letters, case histories, or medical records.
Requirements
Education: High school diploma or GED.
Minimum two to three years of experience in medical billing.
Medical office experience; knowledge of workers’ compensation processes and guidelines.
Knowledge of physician billing processes, 1010A’s and 1009’s, and computer systems.
Advanced computer knowledge, including Windows based programs.
Skill in customer service and understanding of LOS’ code of conduct.
Skill in using computer programs and applications including Microsoft Excel, Microsoft Word, and Outlook.
Skill in establishing good working relationships with both internal and external customers.
Ability to multi-task in a fast-paced environment, be detail oriented with strong organizational skills.
Ability to understand patient demographic information and determine insurance eligibility.
Ability to work independently and analyze data.
Environmental/Working Conditions Normal office environment.
Physical/Mental Demands Requires sitting and standing associated with a normal office environment. Some bending and stretching required. Manual dexterity using a calculator and computer keyboard.
This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.
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