Workers Compensation Authorization & Verification Specialist

Please note: This position falls under the Workers' Compensation Department and is dedicated to supporting functions related to work-related injury claims, compliance, and case management.

Your responsibilities will include:  

• Submit authorization requests timely within EMR, following payer and state specific guidelines  

• Specialize in Workers Compensation Financial Class and fluidity within different state and payer specifics 

• Partner with Front Desk teammates and/or Workers Compensation Centralized Scheduling (WCCS) teammates within clinics to ensure appropriate and accurate documentation for authorization submission is completed and uploaded for submission 

• Provide regular feedback to front desk and/or WCCS regarding areas of opportunity in authorization or verification timeline or process 

• Address and respond to authorization or verification related queries from Ivy teammates and WC Payers 

• Ensure all authorization and verification related denials are addressed timely and accurately, providing denial prevention feedback to WC Team Lead 

• Accurately complete verifications for same day or walk-in patients by contacting the provided insurance via phone, fax, or online portal to obtain outpatient therapy benefits, eligibility, and authorization information 

• Request, follow-up, and secure authorizations prior to and during treatment episode for Workers Compensation patients  

• Assist with training and education for new A&V teammates as well as ongoing training and education for established team members  

• Maintain a professional and collaborative relationship with all teammates and vendors to resolve issues, increase knowledge of insurance requirements, and create standardized workflows  

• Run EMR or BI reports as needed to monitor maximum benefits, missing authorization, or other areas of focus as determined by the A&V Team Lead 

• Attend and participate in Department and Organizational meetings to discuss departmental goals and progress 

• Perform other duties as assigned by leadership staff 

To excel in this role, you should possess:  

• 1 year+ of experience with Workers Compensation insurance in a healthcare environment required; experience with outpatient therapy preferred 

• Demonstrates flexibility in responding to priorities and organizational change

• Demonstrates ability to work under pressure and follow through on assignments

• 2-3 years previous experience in pre-auth verification; experience with obtaining authorizations, referral coordination and patient services preferred 

• Ability to multi-task, prioritize needs to meet required timelines. 

• Customer service experience  

• Effective written and verbal communication skills. 

• Solution oriented mindset and ability to use critical thinking and analytical skills  

• Ability to use standard office equipment to include copiers, fax machines, and other methods of electronic communications. 

• Open availability Monday through Friday from 8am-5pm EST 

• Ability to self-motivate and focus in a remote position 

• Proficient in Microsoft applications 

Why choose Ivy?   

• Best Employer: A prestigious honor to be recognized by Modern Healthcare, signifying excellence in our industry and providing an outstanding workplace culture.  

• Exceeding Expectations: Deliver best-in-class care and witness exceptional patient outcomes.   

• Incentives Galore: Eligibility for full benefits package beginning within your first month of employment. Generous PTO (Paid Time Off) plans and paid holidays. 

• Empowering Values: Live by values that prioritize teamwork, growth, and serving others.

Compensation ranges up to an hourly rate of $23.00 based on experience.

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