Worker's Comp & No Fault Coordinator

Title: Coordinator- Workers Comp No Fault Verification

Reports to: Associate Director of Revenue Cycle

Location - onsite/hybrid: Onsite- Great Neck, NY

Hours: Monday-Friday 8:30 am- 5:30 pm

Who we are:

Spire Orthopedic Partners is a growing national partnership of orthopedic practices that provides the support, capital and operational resources physicians need to grow thriving practices for the future. As a Management Services Organization (MSO), Spire provides the infrastructure for administrative operations that allows practices to operate at their highest level, so doctors can focus their efforts on what matters most - patient care. Headquartered in Stamford, Connecticut, the Spire network spans the Northeast with more than 165 physicians, 1,800 employees, 285 other clinical providers and 40 locations in New York, Connecticut, Rhode Island and Massachusetts.

Responsibilities/Duties:

• Coordinate and collect necessary information from staff, patients, employers, adjusters and payers for claim adjudication
• Communicating directly with insurance carriers on Workers Compensation accounts to verify the cases are open and enter all documentation that includes attorney contacts, case, carrier, date of accident, date of injury and appropriate body part
• AR follow up
• Correspondence review
• Payment posting discrepancies
• Adheres to all HIPAA guidelines and regulation
• Validate WC insurance using the board website
• Review and submit authorizations via WCB Board for applicable payers
• Communicate denials with Clinical and Ops Team
• Communicate approvals with patient and scheduling vendors
• Handle inbound questions regarding authorization and claim statuses
• Work closely with our authorization vendor to ensure timely and accurate authorization submissions