Workers Comp Specialist
Atlantic Health System
To support the AMG Workers Compensation Program, Atlantic Workers’ Compensation Covid Recovery Center, and to act as a liaison between all Atlantic entities and our Workers Comp Managed Care Partners/Workers Comp insurance carriers
PRINCIPAL ACCOUNTABILITIES:
The Workers’ Compensation Specialist will act as a liaison between the entry point of a Workers’ Compensation claimant and all pertinent outpatient facilities involved.
The Worker Compensation Specialist will also be the liaison for Workers’ Compensation Insurance Companies and specialty providers to ensure a seamless transition of information, authorizations, and any other identified documents.
Gathers all documentation from visits and submits to the claims’ adjusters and nurse case managers as required.
Obtains all authorizations for services, documents approvals within the Electronic Medical record, and coordinates and schedules all approved services.
Provides case coordination and oversight in order to streamline and expedite the provision of medical services to maintain good relationships with insurance carriers and Atlantic Health System.
Facilitates all adjuster and nurse case management needs to ensure recurrent referrals.
Ensures needs of patients are being met and that quality customer experiences and outcomes are being delivered.
Provides education and support to providers and providers' staff to ensure proper pre-service, documentation, and authorizations processes are followed.
Works alongside Corporate Health and Managed Care to assist in any other directed care cases as needed.
Compiles daily/weekly/monthly data of incoming referrals and indemnity outcomes.
Compiles and distributes reports as requested.
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