Job Title: Workers’ Compensation Authorization Coordinator

Reports to: Workers’ Compensation Manager

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.

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.

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