Orthopedic Surgery Workers Compensation Specialist
Core
Administrative specialist supporting orthopedic patients with work-related musculoskeletal injuries under workers' compensation insurance, managing claims from evaluation to discharge.
Role type
Workers Compensation Specialist (Administrative/Claims Support)
Builds
Internal workers' comp program, routine reports, active case reports
Domain
Healthcare (Orthopedics) + Workers Compensation Insurance
Deliverable
client delivery
Required skills
Workers compensation program administration, claim investigation and processing, medical scheduling (surgeries, imaging, pre-Op clearance), database management, legal document handling, pre-authorizations, communication with attorneys and adjusters
Preferred skills
Orthopedic clinical setting experience, Workers Compensation Analyst certification
Technologies
Spreadsheets, databases, PowerPoint, Word
Responsibilities
Investigating and processing workers' compensation claims from initial evaluation to surgical and discharge phases; Scheduling and managing appointments including IMEs, surgeries, and imaging diagnostics; Updating internal workers compensation database and producing monthly active case reports; Acting as liaison between physicians, insurance carriers, and legal representatives; Handling claim settlements and litigation issues; Obtaining verification, pre-certification, and pre-authorization for tests and procedures
Seniority
Mid-level, hands-on IC
