Workers’ Compensation (WC) Coordinator- Float, OrthoCarolina, US

At OrthoCarolina, our team is our greatest asset and the foundation of our success. We are a diverse group of individuals, accountable to each other to uphold the standards of excellence and promote an environment of teamwork throughout the organization.  OrthoCarolina has 43 unique care locations with over 1300 professionals who share a common goal to make lives better. Our employees are eligible for a full spectrum of benefits including paid company holidays, wellness programs, and tuition reimbursement. To learn more about Team OC please visit  https://www.orthocarolina.com/about-us 

OrthoCarolina is currently seeking a Workers Compensation Coordinator- Float with the business office.  

The Workers Compensation Coordinator-Float will support the daily operations of the WC Department under the guidance of the WC Support Services Supervisor. This dynamic role provides cross-functional assistance with key administrative tasks such as appointment scheduling, obtaining authorizations, chart management, and patient pre-registration.

Essential Functions:

• Act as a liaison between the organization and WC insurance carriers, adjusters, nurse case managers, and employers.  The coordinator helps ensure efficient communication, timely care coordination, and accurate documentation.
• The floater position offers flexible support across various areas of the department to maintain smooth workflow and prevent delays or denials in WC claims.
• Coordinate and obtain prior authorizations for workers’ compensation services by proactively communicating with Work Comp Insurance Adjusters and Nurse Case Managers, ensuring timely approval and minimizing care delays.
• Maintain and update patient referrals in the EPIC system with accurate authorization data, contributing to accurate billing and seamless patient workflows.
• Manage appointment scheduling for WC patients across multiple practitioners and locations, ensuring alignment with WC coverage guidelines, physician availability, and clinical needs.
• Audit and process pre-registration work queues (WQs) to verify insurance coverage, referral completeness, and authorization accuracy prior to patient appointments.
• Route clinical documentation, including office visit notes, work excuse updates, and upcoming appointment details, to insurance carriers and case managers in a timely and accurate manner to support claims processing and return-to-work decisions.
• Monitor and prevent potential claim denials by identifying documentation gaps or scheduling errors and proactively resolving issues before services rendered.

Skills and Abilities:

• Strong attention to detail with the ability to organize and file materials accurately using alphabetical and numerical systems.
• Ability to maintain strict confidentiality in all aspects of work.
• Excellent customer service skills and the ability to interact professionally with patients, staff, and external partners.
• Effective verbal and written communication skills; able to respond to questions clearly and professionally.
• Knowledge of medical terminology and standard medical office procedures.
• Ability to manage challenging or emotional situations with professionalism and respect.
• Adaptability to changes, delays, or unexpected events; skilled in prioritizing tasks in a dynamic
• environment.

Qualifications:

• Associate degree or bachelor’s degree preferred, or equivalent combination of education and experience.
•  2–3 years of experience in workers’ compensation, with a focus on pre-certification, appointment scheduling, and billing preferred.
•  Prior experience working in the workers’ compensation field is highly desirable.

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