Workers Comp Rep - South Bend

Overview

South Bend Orthopaedics (SBO) provides specialized care for all musculoskeletal surgery and orthopedic rehabilitation patients, as well as those suffering from work-related and sports injuries. Founded on the principle of providing excellence in orthopedics, SBO has been serving the needs of the northern half of Indiana and southern Michigan since 1947 and functions as the Orthopaedic Surgeons for The University of Notre Dame Athletics Department since 1949. Services include joint replacement, sports medicine, upper and lower extremity surgery, pain management, diagnostic imaging, physical and occupational therapy. With 20 physicians and surgeons, plus multiple advanced practitioners across several locations, SBO is proud to be the trusted orthopedic expert for South Bend and the surrounding region - and a proud partner practice of OrthoAlliance.

At SCA Health, we believe health care is about people - the patients we serve, the physicians we support and the teammates who push us forward. Behind every successful facility, procedure or innovation is a team of 15,000 professionals working together, learning from each other and living out the mission, vision and values that define our organization.

As part of Optum, SCA Health is redefining specialty care by developing more accessible, patient-centered practice solutions for a network of more than 370 ambulatory surgical centers, over 400 specialty physician practice clinics and numerous labs and surgical hospitals. Our work spans a broad spectrum of services, all designed to support physicians, health systems and employers in delivering efficient, value-based care to patients without compromising quality or autonomy.

What sets SCA Health apart isn’t just what we do, it’s how we do it. Each decision we make is rooted in seven core values:

• Clinical quality
• Integrity
• Service excellence
• Teamwork
• Accountability
• Continuous improvement
• Inclusion
  
  

Our values aren’t empty words - they inform our attitudes, actions and culture. At SCA Health, your work directly impacts patients, physicians and communities. Here, you’ll find opportunities to build your career alongside a team that values your expertise, invests in your success, and shares a common mission to care for patients, serve physicians and improve health care in America.

At SCA Health, we offer a comprehensive benefits package to support your health, well-being, and financial future. Our offerings include medical, dental, and vision coverage, 401k plan with company match, paid time off, life and disability insurance, and more. Please visit, https://careers.sca.health/why-sca, to learn more about our benefits.

Your ideas should inspire change. If you join our team, they will.

Responsibilities

Position Summary:

Serves as external and internal relations for injured worker and group practice. Responsible for resolution of any issues for which claim may be disallowed. Facilitates access to treatment of a compensable injury or condition.

Position Responsibilities/Standards:

General

• Attend department, clinic or company meetings as required
• Demonstrate sound judgment by taking appropriate actions regarding questionable findings or concerns
• Consistently work in a positive and cooperative manner with fellow staff members.
• Consistently demonstrate ability to respond to changing situations in a flexible manner in order to meet current needs, such as reprioritizing work as necessary.
• Attend required annual in-service programs.
• Demonstrate knowledge and understanding of all company policies and procedures.
• Adheres to established facility safety requirements and procedures to ensure a safe working environment. Identifies potentially unsafe situations and notifies supervisor.
  
  

Specific Duties

• Screen all BWC claims to ascertain status of claim
• Interview injured worked as needed.
• Assist physician/staff regarding injured worker as needed.
• Schedule appointments as needed.
• Update all BWC charts, allowed condition(s), POR, DOI, MCO, Case Manager, etc.
• Review and complete forms necessary for support of claim
• Obtain required authorization for services as needed.
• Follow up on approvals/disapprovals
• Communicate with physicians, Ohio BWC, MCO Case Managers, Self Insured Reps, Employers, Injured workers and attorneys.
• Review physician appointment schedules for BWC patients to determine if there are any outstanding issues.
• Works closely with coders regarding any discrepancies, which may occur as it pertains to services rendered.
• Complete disability forms.
• Answer phones.
  
  

Qualifications

• Must be high school graduate or equivalent.
  
  

USD $19.00/Hr. USD $24.00/Hr.