Worker's Comp & No Fault Coordinator

Hours: Monday-Friday 8:30 am - 5:30 pm

Who we are: 

Spire Orthopedic Partners is a growing national partnership of orthopedic practices that provides the support, capital and operational resources physicians need to grow thriving practices for the future. As a Management Services Organization (MSO), Spire provides the infrastructure for administrative operations that allows practices to operate at their highest level, so doctors can focus their efforts on what matters most – patient care. Headquartered in Stamford, Connecticut, Spire Orthopedic Partners is a growing partnership of orthopedic practices that provides the support, capital and operational resources physicians need to grow thriving practices in today’s evolving healthcare landscape. The Spire network spans the Northeast with more than 165 physicians, 1,800 employees, 285 other clinical providers and 40 locations in New York, Connecticut, Rhode Island and Massachusetts.

Responsibilities/Duties:

• Coordinate and collect necessary information from staff, patients, employers, adjusters and payers for claim adjudication.
• Knowledge of workers’ compensation rules and laws.
• Communicating directly with insurance carriers on Workers Compensation accounts to verify the cases are open and enter all documentation that includes attorney contacts, case, carrier, date of accident, date of injury and appropriate body part.
• AR Follow up
• Correspondence review
• Payment posting discrepancies
• Adheres to all HIPAA guidelines and regulation.
• Validate WC insurance using the board website
• Review and submit authorizations via WCB Board for applicable payers
• Escalate Level 3 authorization submissions
• Communicate denials with clinical and Ops Team
• Communicate approvals with patient and scheduling vendors
• Handle inbound questions regarding authorization and claim statuses.
• Work closely with our authorization vendor to ensure timely and accurate authorization submissions.

Who you are:

Qualifications:

• High School Diploma or equivalent GED.
• Updates the system to record the Workers Compensation Authorization related information.
• Excellent oral, written, computer and customer service skills
• Experience working in a medical office
• Strong communication, problem-solving and analytical skills
• Ability to work independently and in a team environment
• Must have attention to detail with an eye for accuracy
• Proficient in electronic medical records
• Strong follow-up and organizing skills
• 2 years prior with workers compensation/ no fault authorization experience preferred. 
• Working knowledge of medical terminology, abbreviations, and anatomy.
• Knowledge of the New York Workers compensation Board website.
• Workers compensation experience for New York and Connecticut 2 years is required. Rhode Island and Massachusetts a plus.
• Experience with filing claims electronically and on paper.
• Strong attention to detail.    
• Self-directed and motivated to work efficiently.    
• Ability to work in a high-volume patient environment
• Experience with Microsoft Excel and Word.

What we offer: 

• Excellent growth and advancement opportunities 
• Dynamic environment 
• Access to a diverse network of practitioners 
• Broad infrastructure of tools and programs to enhance the employee experience    
• Competitive Compensation 
• Generous PTO  
• Benefits package: health, dental, vision, 401(k), etc. 

We are an equal-opportunity employer. Qualified Applicants are considered for positions and are evaluated without regard to actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex, or gender (including pregnancy, childbirth, and related medical conditions), gender identity or gender expression (including transgender status), sexual orientation, marital status, military service and veteran status, physical or mental disability, protected medical condition as defined by applicable state or local law, genetic information, or any other characteristic protected by applicable federal, state, or local laws and ordinances (referred to as “protected characteristics”).

Salary : $22 - $27