GENERAL SUMMARY OF DUTIES: The Workers’ Compensation Authorization Coordinator is responsible for obtaining pre-authorization for all diagnostics testing and surgical requests.
Essential Job Functions:
Develop and maintain positive working relationships with case managers, adjusters, employers, vendors.
Obtain pre-authorization for all diagnostics, and surgical requests.
Understanding the process and working with Utilization Review.
Phone triage per scenario, document patient questions, consult with medical providers for appropriate and thorough documentation, and return patient phone calls in a timely manner along with verifying patient demographics and insurance information.
Understand & apply workers’ compensation jurisdiction laws and regulations for Mass & RI.
Additional duties as assigned by the Manager to meet department needs.
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Requirements:
High School education or equivalent required.
2-3 years relevant work experience in a medical office setting or related workers' compensation experience required.
1+ year obtaining prior authorizations required, experience supporting an orthopedic office preferred.
Must be self-directed and able to work with minimal supervision and direction.
Skills in oral and written communication.
Knowledge of computer applications for Excel spreadsheets, and word processing.
Must be able to travel to all sites if/when necessary.