The Workers' Compensation Coordinator manages the scheduling of work-related injury appointments and coordinates referrals between providers and payers. They are responsible for obtaining necessary authorizations, verifying patient intake forms, and maintaining accurate records in the patient management system.
The analyst will interpret and manage payer contract terms to maintain accurate fee schedules and maximize reimbursement. They will also collaborate with internal teams to troubleshoot billing issues and identify opportunities for revenue optimization through data analysis.
The specialist is responsible for researching and resolving payment discrepancies and account variances to ensure the integrity of patient accounts. They will perform detailed account analysis, process refunds, and reconcile payment activity using various internal systems and payer portals.
The Quality Specialist performs outbound patient calls to manage medication adherence, close gaps in care, and coordinate with clinical and pharmacy teams. They are responsible for documenting patient care activities in EMR systems and facilitating referrals to ensure high-quality health outcomes.
