Workers Compensation Specialist

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POST DATE 9/16/2016
END DATE 10/18/2016

Beth Israel Deaconess Medical Center Boston, MA

Company
Beth Israel Deaconess Medical Center
Job Classification
Full Time
Company Ref #
17952BR
AJE Ref #
576192746
Location
Boston, MA
Experience
Mid-Career (2 - 15 years)
Job Type
Regular
Education
High School Diploma or GED

JOB DESCRIPTION

APPLY
JOB SUMMARY: The Workers Compensation Specialist acts as a liaison between the patient's employer, physicians and the insurance carriers regarding questions and issues related to Workers' Compensation.

ESSENTIAL RESPONSIBILITIES:

* Obtain all necessary patient information from medical records, physicians and staff to submit employer and Workers Compensation carrier and claim information for emergent and non-emergent cases. Fulfill all authorization requirements for individual payers relating to documentation and condition of the patient.

* Manage the treatment agreement forms for fee agreements and authorization of services.

* Maintain a vigilant stand with the employers and carriers to reach effective lines of communication and establish a non-negotiable stance regarding the fees assessed on the treatment agreements. Maintain clear and constant communication with physicians and staff to keep them informed of the status and outcome of the cases.

* Negotiate treatment agreements with workers compensation carriers and obtain authorizations for services rendered to workers compensation patients.

* Maintain a solid timeline regarding completion of the authorization processes.

REQUIRED QUALIFICATIONS:

* High School diploma or GED required. Bachelor's degree preferred.

* 3-5 years related work experience required.

* Prior experience with workers compensation insurance from either the healthcare or insurance industry.

* Ability to work independently, to set and maintain priortities.

* Advanced skills with Microsoft applications which may include Outlook, Word, Excel, PowerPoint or Access and other web-based applications. May produce complex documents, perform analysis and maintain databases.

PREFERRED QUALIFICATIONS:

* Adjuster's experience/license a plus.

COMPETENCIES:

* Decision Making: Ability to make decisions that are guided by general instructions and practices requiring some interpretation. May make recommendations for solving problems of moderate complexity and importance.

* Problem Solving: Ability to address problems that are varied, requiring analysis or interpretation of the situation using direct observation, knowledge and skills based on general precedents.

* Independence of Action: Ability to follow precedents and procedures. May set priorities and organize work within general guidelines. Seeks assistance when confronted with difficult and/or unpredictable situations. Work progress is monitored by supervisor/manager.

* WRITTEN COMMUNICATIONS: Ability to summarize and communicate in English moderately complex information in varied written formats to internal and external customers.

* ORAL COMMUNICATIONS: Ability to comprehend and communicate complex verbal information in English to medical center staff, patients, families and external customers.

* KNOWLEDGE: Ability to demonstrate in-depth knowledge of concepts, practices and policies with the ability to use them in complex varied situations.

* TEAM WORK: Ability to work collaboratively in small teams to improve the operations of immediate work group by offering ideas, identifying issues, and respecting team members.

* CUSTOMER SERVICE: Ability to provide a high level of customer service to patients, visitors, staff and external customers in a professional, service-oriented, respectful manner using skills in active listening and problem solving. Ability to remain calm in stressful situations.

AGE BASED COMPETENCIES:
Employees in this job must be competent to provide patient care to the following age g.
PHYSICAL NATURE OF THE JOB:
Sedentary work: Exerting up to 10 pounds of force occasionally in carrying, lifting, pushing, pulling objects. Sitting most of the time, with walking and standing required only occasionally

EOE Statement
BIDMC is EOE M/F/VET/DISABILITY/GENDER IDENTITY/SEXUAL ORIENTATION

Beth Israel Deaconess Medical Center is an Equal Opportunity Employer. We comply with the laws and regulations set forth in the linked poster:http://www.dol.gov/ofccp/regs/compliance/posters/pdf/eeopost.pdf