Workers Compensation Claims Specialist

4 weeks ago


Grapevine, Texas, United States North Texas Orthopedics and Spine Center Full time

Job Title: Workers Compensation Claims Specialist

Job Summary: We are seeking a highly skilled Workers Compensation Claims Specialist to join our team at North Texas Orthopedics and Spine Center. The ideal candidate will have a strong background in customer service, work comp related experience, and excellent communication skills.

Key Responsibilities:

  • Respond to telephone inquiries relating to the medical practice's policies and procedures.
  • Making new patient appointments for Workers Comp patients and new patients to the practice.
  • Fill out intake form for Workers Comp.
  • Call adjuster to get authorization for the clinic to treat the patient.
  • Call patient back and make appointment.
  • Making sure we get correct or updated information on the patient.
  • Responds to patient inquiries, assistance on which department to speak with etc.
  • Reading Comprehension — Understanding written sentences and paragraphs in work related documents.
  • Active Listening — Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.
  • Speaking — Talking to others to convey information effectively.
  • Writing — Communicating effectively in writing as appropriate for the needs of the audience.
  • Critical Thinking — Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
  • Create & verify new workers' compensation cases;
  • Obtain authorizations for applicable new patient treatments;
  • Communicate promptly with adjusters and work case managers;
  • Prepare and complete all letters and paperwork required;
  • Communicate case information with patients;
  • Fax patient notes;
  • Manage all incoming calls from WC patients and representatives; address concerns and billing inquiries; may require interactions with patients in clinic

Requirements:

Education: High school diploma or equivalent. Some college is preferred.

Experience: Minimum one-year experience in customer service, work comp related, appointment scheduling and phone etiquette preferably in the health care industry. Outstanding communication skills.



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