Accounts Receivable Work Comp Financial Coordinator

Position Overview

Since 1972, Orlando Orthopaedic Center has remained independently owned and has grown to include 24 orthopaedic specialists across multiple subspecialties, many of whom are recognized leaders amongst their peers nationwide. We have nine locations throughout Central Florida, plus a state-of-the-art outpatient surgery center and several walk-in clinics serving the community. For over 50 years, our physicians and support staff have been helping Central Floridians get back to work, play, and make a difference in our community.

POSITION:

RESPONSIBLE TO:

JOB SUMMARY:

Key Responsibilities

• Understand how to interpret authorization and coverage for a procedure using the WC manual.
• Analyze and work outstanding AR WC reports and Practice Management Queues.
• Identify claims with missing documents and forward them to the clearing house.
• Prepare charts for settlement notices and notify all appropriate departments.
• Research appointment errors related to workers compensation (WC).
• Identify, research, and submit appeals for low pay, no pay, and denials to ensure appropriate payment.
• Identify inappropriate payment or denial trends and notify the AR Manager.
• Update and repost any revised WC charge information.
• Research EHR messages from DME and charge entry and update accounts accordingly.
• Review the clearing house upfront edits and rejections on a daily basis.
• Update MMI status and notify all appropriate departments.
• Review any refund requests from WC carriers.
• Analyze and process scrubbers prior to spooling claims.
• Coordinate all WC correspondence and clinical paperwork using approved forms for appeals.
• Complete special projects related to WC claims as designated by the AR Manager.
• Review all WC correspondence to ensure charts are properly built with correct insurance attachments.
• Handle all incoming WC telephone calls and document actions taken in the patient chart.
• Respond to inquiries from nurse case managers and health insurance carriers, both written and verbal.
• Process WC correspondence related to billing inquiries (e.g., PSA forms, IME forms, contributing cause letters).
• Maintain patient confidentiality and comply with HIPAA and practice compliance guidelines.
• Maintain detailed knowledge of practice management systems, EHR, and related computer software.
• Attend continuing education courses as requested.
• Perform all other duties as assigned by the AR Manager.

Required Qualifications

• Education: High school diploma required
• Strong accounting computer skills required
• Qualifications: Two years’ experience in accounting, data entry or medical payment posting
• Must be proficient in Excel and in creating Word documents
• Must be detail oriented with the ability to perform multiple and diverse tasks simultaneously
• Strong written and verbal communication skills; must maintain a cheerful attitude

Preferred Qualifications

• Education: Advanced Degree or Certification preferred
• Qualifications: Knowledge of ICD-10 and CPT Codes preferred

Benefits & Perks

• 401(k) matching
• Dental insurance
• Employee discount
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid sick time
• Paid time off
• Referral program
• Vision insurance