The specialist is responsible for verifying workers' compensation injuries, auditing medical records for billing accuracy, and serving as the primary point of contact for adjusters and case managers. They also facilitate physician understanding of treatment guidelines and manage the timely follow-up of unpaid claims.
The Referral Coordinator serves as the primary point of contact for patients, ensuring a positive experience through professional communication and efficient service. Responsibilities include managing appointment scheduling, handling clinical messaging in the EMR system, and coordinating referrals with external provider offices.
The specialist is responsible for preparing and submitting clean insurance claims and managing the accounts receivable process. They must also resolve billing complaints, process refunds, and document all collection activities in accordance with HIPAA regulations.
