Claims Coordinator

4 weeks ago


Daytona Beach, Florida, United States The Orthopedic Clinic Full time
The Orthopedic Clinic is seeking a skilled Workers Compensation Coordinator to provide exceptional service to our private practice Workers Compensation line of business. Key responsibilities include translating and maintaining working knowledge of work comp regulations and guidelines, coordinating appointments, processing claims, calculating the costs of service, and processing work comp A/R claims. The ideal candidate will possess previous experience with worker comp claims, proficiency in Microsoft Office Products, EPM and EHR software applications, preferably Athena, and excellent customer service skills. As a Workers Compensation Coordinator, you will be skilled in maintaining effective working relationships with co-workers, third party payors, and patients while maintaining exemplary customer service skills and a passion for quality healthcare. Key responsibilities include:

Processing Workers Compensation referrals, appointments and claims.
Filling out and processing authorization forms for the appropriate appointment type, i.e. special evaluation, IMEs.
Preparing DWC-25 and transmitting to appropriate parties.
Preparing insurance claim forms or related documents and reviewing them for completeness.
Skilled in exercising a high degree of initiative, judgement, discretion, and decision-making to achieve organizational objectives.
Answering inquiries and correspondence from carriers, referring physicians offices and insurance companies.
Reading and comprehending explanation of benefits/HCFA forms.
Responsible for taking action on non-payment or zero pay claim, including contacting insurance companies as needed to diagnose, correct, and rebill claims.
Responsible for providing any information (medical records, itemized statements, etc.) required by insurance companies to overturn denied claims.

Requirements:

Minimum of High School Diploma.
Previous workers comp experience in private practice.
Previous customer service experience, preferably in medical/healthcare setting.
Proficiency in the use of Microsoft Office Products, EPM and EHR software applications, preferably Athena.
Valid Driver's License / Clean driving record / Proof of auto insurance.

The Orthopedic Clinic is an Equal Opportunity Employer and fully subscribe to the principles of Equal Employment Opportunity. Applicants and/or employees are considered for hire, promotion and job status, without regard to race, color, citizenship, religion, national origin, age, sex (including sexual harassment, sexual orientation, and gender identity), disability or handicap, genetic information, citizenship status, veteran, or current or future military status or any other category protected by federal, state, or local law.

The Orthopedic Clinic is a drug free workplace all applicants under consideration for employment will be background checked as part of the hiring process.

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