Occupational Health Coordinator
Objective:
Under the general supervision of the Director of Occupational Health, the Occupational Health Coordinator assists in coordinating the claim and service need as it relates to occupational health services and workers’ compensation injury visits. Coordinators will ensure that occupational services performed are reported in a timely manner. Coordinators will facilitate the processing of workers’ compensation injury visits inclusive of, but not limited to DWC-25s, claim number attainment, treatment authorization, referrals, and authorizations for ancillary, specialty, and diagnostic needs. Provides and ensures excellent customer service for our patients, employers, and workers’ compensation carriers/adjusters/nurse case managers.
Responsibilities:
- Ensures accuracy and completion of all occupational health services authorized by the employer and/or carrier.
- Ensures each claim has accurate claim information such as insurance carrier, employer contacts, and claim numbers.
- Coordinates center-level or provider-level documentation corrections, changes, or updates.
- Facilitates all inbound communication to the Occupational Health Department such as phone calls, emails, and faxes.
- Responds timely and professionally to requests made by employers, carriers, patients, and referral entities.
- Processes submission of applicable workers’ compensation documents to employer and workers’ compensation carrier contacts; inclusive of, but not limited to DWC-25, visit summary notes, referrals, billing, etc.
- Manages referrals made by providers to ancillary, specialty, or diagnostic providers by securing authorization and assisting in the scheduling of appointments for the patient.
- Facilitates appointments and non-compliance protocols.
- Develops and maintains working rapport with all referral sources and associates for optimal proficiency.
- Ensures accuracy in billing documentation including accurate fee schedules, visits & procedure codes.
- Processes claim to Worker’s Compensation Insurance, Third-Party Administrators (TPA), Employers, and other payers.
- Creates invoices and billing materials to be sent directly to Employers or TPAs.
- Collaborates with patients, clients, TPA, and other team members to resolve billing inconsistencies and errors.
- Manages denial notifications.
- Ensures compliance with HIPAA standards and regulations.
- Performs other job-related activities and duties as assigned by leadership.
- Assists and covers for other staff when necessary to maintain high productivity and efficiency in the department.
- Strong oral and written communication is required.
Required Qualifications
Education:
- An associate’s degree in Billing & Coding, Health Care Services, Medical Administrative Assistant, or a related field is helpful.
Experience:
- Working knowledge of the Insurance, Workers’ Compensation rules and systems including statutes, treatment parameters, and billing process is helpful.
- 3 years experience in the Healthcare field or related field.
- 3 years experience in Referral Coordination and/or Billing & Coding.
- Computer Literate: eClincalWorks, Excel, Word, and Outlook are required.
Working Conditions:
- Air-conditioned and well-illuminated office environment.
- May have several responsibilities at once.
- Interaction with others is constant and can be disruptive to planned daily activities.
- Work may be stressful at times due to the demands of stakeholders.
- Walking/sitting for extended periods of time.
- Availability on weekends, holidays, and evenings might be required to comply with the purpose of the job.
- Occasional overtime may be required and/or hours shortened as business needs dictate.
Physical and Mental Demands:
- Excellent interpersonal and communication skills; listening skills, conflict resolution, and problem-solving.
- Self-starter: takes initiative to identify opportunities.
- Ability to express ideas concisely and clearly, orally and in writing.
- Demonstrates sound judgment, common sense, and professionalism in all areas.
- Talk and hear both by person and by telephone; ability to speak clearly and effectively using proper grammar before patients and business partners, among others.
- Manages conflicting priorities.
- Use hands to finger, handle, feel or operate standard office equipment and clinical instruments and supplies. Reach with hands and arms. Visual sharpness is required.
- Detail-oriented and excellent organizational skills.
- Ability to accept constructive criticism and function effectively as part of a team.
- Ability to function independently and with flexibility.
- Ability to work under pressure. Able to handle multiple tasks and interruptions.
- A well-groomed, business-like appearance.