Jobs Companies Sharp HealthCare Workers Comp Coordinator - Sharp TriCity - Day Shift - Full Time

About this Workers Comp Coordinator - Sharp TriCity - Day Shift - Full Time role at Sharp HealthCare

Sharp HealthCare · Onsite · STCMC OSNC - Oceanside - 3905 Waring Road

Hours:

Shift Start Time:

8 AM

Shift End Time:

4:30 PM

AWS Hours Requirement:

8/40 - 8 Hour Shift

Additional Shift Information:

Weekend Requirements:

No Weekends

On-Call Required:

No

Hourly Pay Range (Minimum - Midpoint - Maximum):

$25.000 - $26.320 - $31.160


 

The stated pay scale reflects the range that Sharp reasonably expects to pay for this position.  The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant’s years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices. 


 


What You Will Do
The Worker's Compensation Coordinator works with Worker's Compensation patients; schedules new and existing appointments, completes registration in the practice management system, submits authorizations, functions as a liaison for patients between adjusters, employers and physician teams.  The Worker's Compensation Coordinator will work with the practice patients, clinical teams and business office on accurately preparing the patient for their physician, MRI or Physical Therapy visit.  This position takes incoming calls, enters basic demographics; email, social security, insurance, and financial data into the Practice Management System.  The Worker's Compensation Coordinator will ensure that the patient has access to the patient portal, sends all forms and receives completed forms prior to the patient visit.  They will ensure that patient satisfaction goals are met or exceeded.

Required Qualifications
  • H.S. Diploma or Equivalent
  • 1 Year year of experience in health care.
  • 2 Years of billing and claims experience.

Preferred Qualifications
  • Bachelor's Degree
  • Worker’s Compensation authorization and claims processing experience.

Essential Functions
  • The position characteristics reflect the most important duties, responsibilities and competencies considered necessary to perform the essential functions of the job in a fully competent manner. They should not be considered as a detailed description of all the work requirements of the position. The characteristics of the position and standards of performance may be changed by TCMC with or without prior notice based on the needs of the organization.
    Maintains a safe, clean working environment, including unit based safety and infection control requirements.
    Prepares medical charts and records for patient visits
    Reviews specific protocols requested by client and advise specialty physician accordingly
    Obtain authorizations from clients and insurance carrier for orthopedic treatment as prescribed by physicians.   Report denials or delays to operations manager
    Obtain authorizations for patient referrals to specialists, diagnostic testing and surgeries
    Advise physician in authorization request is denied
    Maintain records of all referrals
    Makes appointments for patients with specialists
    Contacts patients who miss an appointment and/or report missed appointment to employer
    Processes and mails or faxes reports to employers and insurance carriers
    Mails or faxes status update reports
    Tracks receipt of transcription reports.  Reviews reports and files in orthopedic chart. Distributes copy of report to referring physician who will initial and return the report.  Files report in patient’s medical chart.  Mails reports to employers and insurance carriers
    Files final copy of authorized referrals in patient file for physician review
    Utilizes formal channels of communications to report concerns, personal requests and patient issues
    Respects patient’s right to privacy and confidentiality
    Understands and follows department’s organizational policies and procedures
    Assists billing office with claims processing
    Performs other related duties as requested
    Ensures that patient confidentiality is always protected, both audible and visible.
    HIPAA Notice of Privacy Practices is on display and given to all new patients and then every three years.
    Ensure compliance with all medical practice regulations, such as, but not limited to HIPAA and OSHA.

Knowledge, Skills, and Abilities
  • Strong background in customer service.
  • Competencies in the areas of leadership, teamwork and cooperation.
  • Strong ethics and a high degree of personal and professional integrity.
  • An effective communicator at all levels in the organization, with strong oral, written and persuasive skills.

Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class


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About Sharp HealthCare

Sharp HealthCare is a not-for-profit health care system based in San Diego, California, with four acute care hospitals, three specialty hospitals, three medical groups and a health plan. We provide medical services in virtually all fields of medicine, including primary care, heart care, cancer, orthopedics, women’s health, rehabilitation, robotic surgery and bariatric surgery. Sharp sets the community standard for exceptional care. Sharp Grossmont Hospital and Sharp Memorial Hospital have received prestigious Magnet recognition by the American Nurses Credentialing Center for excellence in nursing practices and quality patient care. At the heart of our organization are more than 18,000 affili

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