Worker's Compensation Specialist at Conway Medical Center – Conway, South Carolina

Position Title: Worker's Compensation Specialist

Position Summary: The Workers' Compensation Specialist will primarily support the Orthopedic physicians. The WCS will work closely with nurse case managers, insurance adjusters, attorneys, and other stakeholders to ensure smooth and efficient coordination of workers' compensation cases. The WCS will manage a wide range of tasks, including invoicing, assisting with Maximum Medical Improvement (MMI) determinations, arranging second opinions, coordinating Independent Medical Examinations (IMEs), and handling takeover of care requests.

Qualifications:

Education:

• High School Diploma or equivalent required.

Experience

• Previous experience coordinating workers' compensation cases in a healthcare setting.
• Familiarity with medical billing, coding, and invoicing related to workers' compensation.
• Experience working directly in workers' compensation, preferably within an orthopedic setting.
• Strong understanding of workers' compensation processes, regulations, and medical terminology.
• Excellent organizational and multitasking skills with a keen attention to detail.
• Strong interpersonal and communication skills, with the ability to build and maintain professional relationships with various stakeholders.
• Proficiency in using electronic medical records (EMR) systems and other relevant software.
• Ability to work independently and collaboratively in a fast-paced environment.

Duties & Responsibilities:

• Collaborate with Orthopedic physicians to manage and coordinate all aspects of workers' compensation cases.
• Serve as the primary point of contact between the clinic, nurse case managers, insurance adjusters, and attorneys.
• Oversee the preparation, submission, and tracking of invoices related to workers' compensation cases.
• Facilitates opportunities of growth
• Assist in determining Maximum Medical Improvement (MMI) and ensure appropriate documentation is provided.
• Coordinate second opinions and Independent Medical Examinations (IMEs) as required.
• Manage and process takeover of care requests, ensuring a seamless transition for new cases.
• Maintain accurate records and documentation in compliance with relevant regulations and organizational policies.
• Communicate effectively with all stakeholders to provide updates, answer inquiries, and resolve any issues promptly.
• Proactively identify opportunities to increase the volume of worker’s compensation cases by building and strengthening relationships with referring entities, such as employers, insurance companies, and case managers.
• Stay informed on changes in workers' compensation laws, regulations, and best practices to ensure compliance and provide quality service.