[Hiring] Workers' Compensation Coordinator @Summit Health

Role Description

The Workers’ Compensation Coordinator is responsible for the scheduling of all Summit Health Workers’ Compensation appointments, in addition to the coordination of referrals, whether from CityMD to Summit Health or Summit Health to Summit Health. The individual will be expected to collaborate with payers (adjusters, nurse case managers, claims examiners), employers, and patients to obtain initial authorizations to treat, verify pre-visit intake information, and obtain pre-authorizations.

• Schedule Workers’ Compensation appointments in a timely manner, whether from CityMD referral or external payers/patients.
• Obtain initial authorizations to treat and pre-authorizations for advanced treatment orders from payer contacts (nurse case managers, adjusters, etc.) before scheduling.
• Build patient Athena chart and register accordingly by ensuring Workers’ Comp Case Policy is up-to-date with claim information and authorization details, and linked to the appointment.
• Verify required Workers’ Compensation intake forms are completed by the patient pre-visit; engage with patient if forms are not completed; make updates in Athena where necessary.
• Communicate with patients and payer contacts, via phone and email, in a professional and courteous fashion when needed to discuss Workers’ Compensation information, patient preferences, appointment coordination, etc.
• Conduct outbound calls to employers, adjusters, and nurse case managers regarding CityMD referrals ordered, Workers’ Compensation information needed, appointment scheduling, etc.
• Assist and manage inbound calls and emails from employers, adjusters, nurse case managers, and patients regarding Workers’ Compensation referrals and appointments.
• Review cancelled Workers’ Compensation appointments, communicating any appointment changes to the adjuster/nurse case manager, and facilitate rescheduling the patient.
• Engage with Summit Health offices directly who have scheduled appointments on their own and do not comply with centralized Workers’ Compensation workflows/resources.
• Leverage CRM Salesforce to reference client (employer and payer) referral coordination needs and special instructions.
• Utilize Referwell referral management technology to determine the most appropriate provider for scheduling a referral.
• Track all activities and progress of referral cases and appointments scheduled (outreaches, referral status, appointment scheduling progress, etc.)
• Daily extensive computer use navigating multiple applications while engaging in conversations with payer contacts, employers, patients, or clinical office staff.
• Follow all HIPAA and any other governmental or state agency requirements regarding the appropriate handling of PHI documents to patients, employers, payers, and providers.
• Must adhere to the call center schedule while being accountable to follow specific call quality guidelines and measurements.
• Demonstrate exemplary customer service skills.
• Work closely with other departments including but not limited to Workers’ Compensation Case Management, UC Referral Management, Aftercare, Medical Records, Compliance, and Revenue Cycle with the goal of ensuring that Summit Health-CityMD is providing high quality and appropriate care to all work-related injury patients and ensuring seamless operation processes for customer experience.
• Collaborate with Sales, Employer Concierge Services, and Operations Teams to resolve issues and ensure the highest level of customer satisfaction.
• Other relevant duties as assigned.

Qualifications

• Bachelor’s Degree in Public Health, Business, Hospitality Management or other applicable degree preferred
• Experience with Patient Scheduling preferred
• Experience working in a Call Center preferred
• Experience managing Workers’ Compensation appointments and patients
• Experience working with payer contacts (nurse case managers, adjusters, etc.)
• Computer: Microsoft Office (Excel), CRM (Salesforce), Outpatient scheduling system (i.e., Athena, Epic, Referwell)
• High attention to detail
• Exceptional interpersonal and communication skills (verbal and written)
• Positive attitude and ability to project this around others
• Ability to work in a fast-paced, ever-changing environment
• Works well independently and in a team environment
• Bilingual in Spanish a plus
• Must exhibit passion for outstanding results and compassion for those we work with and serve

Requirements

• This is a non-exempt position with the salary range of $20.00 - $23.00/hour based on experience.
• The provided compensation range is based on industry standards and salary determinations will be made based on numerous factors including but not limited to years of experience and location of position.

Benefits

• Participation in VillageMD’s benefit platform includes Medical, Dental, Life, Disability, Vision, FSA coverages, and a 401k savings plan.