Workers Compensation Coordinator Full-time

About us:
Hughston Clinic Orthopaedics has an exciting opportunity to join our family as a Workers Compensation Coordinator.

At Hughston Clinic Orthopaedics, we put patients first. For over 76 years, Hughston has remained committed to providing high quality patient care. We have several locations in Nashville and the surrounding cities in Middle Tennessee.

Our mission is to provide world-class service for all our patients. We strive to be the best provider in orthopedic care, and continue to support and encourage our patients to resume a more active lifestyle. We are looking for candidates who put the needs of patients above all else, are ethical and honest, treat everyone with dignity and courtesy, and do the right things in the right way.

Hughston offers competitive pay plus comprehensive benefits, including Medical, Dental, Vision, Paid Time Off, Holiday Pay and more. Our 401(k) plan provides a company safe harbor contribution to help you get started in saving for your retirement.

Position Goal:

Maintains overall understanding of assigned payor to include what is covered versus non-covered serves as a liaison between clinic and assigned payor.

Position Responsibilities:

• Ensure workers’ compensation process is performed accurately with all team members. Responsible for training and re-training on W/C protocol as needed.
• Organize clinic claims for electronic or hard copy mail and forward to appropriate workers compensation payors.
• Serve as key contact for all workers’ compensation inquiries. Provide reports to management as needed.
• Answer multi-phone lines and return messages in a timely manner.
• Review claims to make sure that the payor specific billing requirements are met, follow up on billing, determine and apply appropriate adjustments, answer questions and update accounts as necessary.
• Manage assigned Payor hold/Manager hold buckets.
• Responsible for implementing solutions as needed for escalated issues.
• Assist patients with questions/payments on their accounts.
• Appropriately appeal insurance claims in a timely manner.
• Research and write up refunds.
• Work assigned buckets in EMR system and respond to phone calls/messages in a timely manner.
• Educate and direct patients and/or adjusters and employers to the State Bureau of Workers Compensation when needed or necessary.

Experience:

Required: One year insurance claims/related experience.

Education:

Required: High School Diploma or equivalent required.

Special Qualifications:

Required:

• Familiar with standard concepts, practices, and procedures of this particular field.
• Ability to work independently.
• Maintain effective oral and written communication with patients, employers, case managers, physicians, and staff.
• Knowledge of workers compensation principles and practices.
• Basic knowledge of orthopedic medical terminology to help prioritize urgent vs. non-urgent visits.
• Ability to accurately investigate necessary workers compensation paperwork.
Must have a valid driver’s license and satisfactory motor vehicle record (MVR.) Travel is required.

The Hughston Clinic, The Hughston Foundation, The Hughston Surgical Center, Hughston Clinic Orthopaedics, Hughston Medical and Jack Hughston Memorial Hospital participate in E-Verify. This company is an equal opportunity employer that recruits and hires qualified candidates without regard to race, religion, color, sex, sexual orientation, gender identity, age, national origin, ancestry, citizenship, disability, or veteran status.