WC Referral Coordinator

Company: Coastal Medical Group
Location: Irvine
Posted on: March 17, 2023

Job Description:

Description:About Us: Our physicians offer a full scope of occupational medicine services designed to help reduce healthcare costs, while minimizing lost work time and increasing employee productivity. To accomplish these goals, Akeso is outcome focused and provides medical care on an urgent or appointment basis for occupational injuries and illnesses. We also design modified work and rehabilitation programs to enable injured employees to return to work as soon as possible.We offer a comprehensive benefits package including health benefits, matching 401k, paid vacation, sick, holidays and more!Summary /Objective: As a WC Referral Coordinator, you will contribute to the patient experience from start to finish. This role demands multi-tasking in a fast-paced environment. Your role will be to help coordinate in-house occupational health medical treatment requests by directing and facilitating referrals between medical providers and when needed partnering ancillary facilities.If you have the ability to represent the highest quality of care in all aspects of patient engagement, and a willingness to demonstrate a very caring and respectful demeanor we want to hear from you. The ideal candidate will reflect our mission of offering highly personalized, compassionate care and be excited by the opportunity to learn and grow with the Practice. Candidate should also be able to demonstrate a positive attitude, strong communication, and computer skills.Essential FunctionsManeuver patient medical care while working closely with physicians, case managers and worker's compensation adjustersReview occupational health Requests for Treatment Authorization (RFA) for completion and submission to claims administratorsAssists Occ Health providers with treatment coordinationManage follow-up requests and authorization amendments with claims administratorCoordinate and scheduled authorized treatments such as diagnostics and physical medicine at outside facilities for patients across multiple clinicsProvide status updates to patients as well as notify staff/physicians of authorizations and/or denialsProvide excellent customer service by acting as a liaison for employers, insurers, case managers and worker compensation adjustersSupport Referral SpecialistsOther duties include coordinating in-house therapy with clinic staff; scheduling patient's initial appointment with in-house specialists; reviewing claims MPNs and Ancillary Vendor lists for scheduling; obtaining additional information from physicians as needed; follow-up on delayed/missing determinationsRequirements:Excellent communication skills and accurate data entryStrong written and verbal communication skillsDetailed oriented with strong organizational and time management skillsAbility to work alone, take the initiative, and work with little directionMust have a strong sense of discretion, urgency, and professionalismShould be able to work as part of a team as well as work independentlyCollaboration SkillsEthical ConductThoroughnessEducation/Experience/Skills:At least 2 years of work experience in a similar roleMust have a positive helpful attitude and ability to discuss issues with manager, physicians, and colleagues and relay information in a timely mannerPossesses knowledge of Workers' Compensation and medical terminologyStrong customer service skillsMust have the ability to build trust with physicians, employers, claims adjusters, and case managersShould have knowledge of electronic medical record (EMR) systems and have the ability to keep up in a fast-paced environmentPreferred Qualifications:Knowledge of Medical terminologyExperience in CA Workers' CompensationBilingual Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.The base salary is determined on the candidate's education, qualifications, and experience, and is subject to change based on various internal and external factors.Akeso is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.PI208085893

Keywords: Coastal Medical Group, Irvine , WC Referral Coordinator, Other , Irvine, California