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    work comp integrated specialist - Tampa, United States - Florida Orthopaedic Institute

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    Description
    Job Details

    Job Location
    North Tampa Office - Tampa, FL

    Position Type
    Full Time

    Job Category
    Worker's Compensation

    Description

    The

    Work Comp Integrated Specialist


    is responsible for the coordination of referrals and authorizations from the insurance carrier, case management and/or employer in accordance to the company and state requirements while exhibiting excellent customer service.


    Key Responsibilities:
    Follow the Florida state and federal Workers Compensation fee schedule and guidelines
    Register and update patient demographics and insurance information in the system
    Schedule appointment(s) according to the patient need and physician protocol
    Obtain written authorization and required documentation for service(s) from the insurance
    carrier, case manager and/or employer
    Ensure updated authorization is documented in the system
    Communicate with the patient advising of the scheduled appointment(s)
    Handle incoming calls and triage to the respective departments as needed
    Send required documentation to the carrier and/or case management as instructed
    Reschedule bumped appointment(s), and notify the patient and carrier of the schedule change
    Conduct a quality check on the internal document(s) prior to sending to the carrier and/or case management
    Reviews a portion of claims prior to the submission to the insurance carrier(s)
    Works with the insurance carriers, third party and vendors to resolve payment and authorization issues
    Serves as an internal escalation point of contact for other departments as needed
    Identify improvement opportunities and provide solutions to management
    Address internal and external email and fax correspondence as instructed
    Ability to meet productivity and accuracy standards
    Collaborate with the various departments to improve the customer experience
    Assure compliance with all company plans, policies and procedures set forth by the Florida Orthopaedic Institute
    All other duties as assigned.

    Qualifications
    High School Diploma or General Education Degree (GED)
    Required 2+ years Florida and Federal Workers Compensation experience
    Requires comprehensive knowledge of computer skills including Microsoft Office Suite
    Excellent customer service and communication skills
    Knowledge of ICD10, CPT HCPCS, bill types and the use of modifiers
    Working Knowledge of medical terminology and human anatomy
    Recommended knowledge of Six Sigma process improvement tools and methodologies
    Must be detail oriented, handle multiple inquiries at a time, resourceful and a self-starter
    Adapt in a fast-paced working and team environment

    #J-18808-Ljbffr


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