Worker's Compensation Specialist- Jacksonville Florida

At Southeast Orthopedic Specialists, we are dedicated to taking care of you so you can take care of business! Our robust BENEFITS PACKAGE includes the following:

• Competitive Health & Welfare Benefits
• Monthly $43 stipend to use toward ancillary benefits
• HSA with qualifying HDHP plans with company match
• 401k plan after 6 months of service with company match
• Employee Assistance Program Available 24/7
• Employee Appreciation Days & Events
• Paid Holidays & Paid Time Off
• AND MORE!

As Southeast Orthopedic Specialists continues to grow, we are hiring A Workers Compensation Specialists for our Central Business Office located in Jacksonville, FL! Please see the information provided below for the functions and requirements needed in order to be considered for this role:

GENERAL SUMMARY
The Workers Compensation Specialist will be responsible for answering all incoming calls and emails to the Workers Compensation Department, setting up new patient charts, setting appointments, obtaining authorizations, providing end of visit documentation to insurance carriers, and processing outgoing claims. Specialists will also assist patients, nurse case managers, and adjusters with any requests or needs. Specialists will assist physicians and their teams with any questions or needs regarding workers compensation claim patients.

ESSENTIAL FUNCTIONS

• Takes inbound calls from patients and insurance to set up patient charts, schedule appointments. Answers questions and provides information pertaining to well-defined areas, which require interpretation of policy.
• Reviews accounts and forms for accuracy and completeness.
• Responsible for sending documentation and orders for each patient visit to the correct carrier.
• Interacts with claims adjustors to verify patients work status and scheduled appointments.
• Communicates verbally and in writing regarding interpretation of local and out of state guidelines and policies.
• Maintains all records and reports.
• Responds to telephone calls from internal staff, patients, adjustors, and case managers.
• Obtains authorizations for initial visits, surgeries, and physical therapy.
• The job holder must demonstrate current competencies for job position.

EXPERIENCE

• This position will accept any one of the below experiences as qualification:
• One-year medical billing or medical business office experience in physician office or hospital environment, One-year customer service experience in retail, sales, or insurance or One-year experience in the insurance industry.
• Workers' Compensation experience is always preferred.

EDUCATION

• High school diploma/GED.

REQUIREMENTS

• Excellent verbal and written communication skills.
• Experience working with Microsoft applications including Word. Excel, and Outlook.
• Ability to work productively in a fast-paced environment.
• Ability to learn and retain company policies, state and federal policies, and workflow processes.

KNOWLEDGE

• Knowledge of worker’s compensation and/or healthcare insurance
• Knowledge of physician group operation and clinic policies.
• Knowledge of authorization and verification processes.

SKILLS

• Skill in the billing authorization process.
• Skill in obtaining necessary approvals for Worker’s Compensation to reduce denials.

ABILITIES

• Ability to proficiently use arithmetic calculations in data collection and interpretation.
• Ability to use interpersonal skills to establish/maintain cooperative relationships with patients, families, physicians, management and other staff.
• Ability to communicate openly and honestly with management and staff.

ENVIRONMENTAL WORKING CONDITIONS

• Normal office environment

PHYSICAL/MENTAL DEMANDS

• This can occasionally be a high-stress work area requiring ability to make quick decisions, while being organized and prioritizing appropriately.