What are the responsibilities and job description for the Workers Compensation Specialist position at Pinnacle Orthopaedics & Sports?
Description
We are seeking a detail-oriented and proactive Workers' Compensation Specialist to join our dynamic team. This role offers an excellent opportunity to contribute to efficient claims management and support our commitment to employee well-being. The ideal candidate will be organized, communicative, and capable of managing multiple responsibilities in a fast-paced environment.
Key Responsibilities:
- Fax work status updates and office notes to relevant parties
- Process and mail out workers' compensation claims
- Obtain necessary information and complete paperwork for Independent Medical Examinations (IMEs) and second opinions
- Schedule IME and second opinion appointments, calculate prepayments, and follow up to ensure timely completion
- Scan, sort, and prepare all IME and second opinion records for physician review prior to appointments
- Serve as a backup for workers' compensation claims processing
- Respond to questionnaires from attorneys, labs, and diagnostic providers
- Obtain authorizations for all workers' compensation diagnostic tests and physician referrals, including MRI, CT scans, FCE, EMG, DME, work hardening, and consults
- Secure surgery authorizations as needed
- Coordinate scheduling and follow-up to ensure smooth claims processing and treatment plans
Requirements
Skills and Qualifications:
- Prior experience in workers' compensation claims processing or related healthcare administration
- Strong organizational and time management skills
- Excellent communication skills, both written and verbal
- Ability to handle sensitive information with confidentiality
- Proficiency in using office software, including email, scanning, and document management systems
- Knowledge of workers' compensation laws, procedures, and medical terminology
- Ability to multitask and prioritize in a fast-paced environment
- Attention to detail and accuracy in documentation and record-keeping
Join our team and be part of a supportive, growth-oriented environment that values professionalism and dedication. We offer opportunities for career development, comprehensive benefits, and a collaborative workplace culture committed to excellence in employee care and service.
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