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Workers Compensation Specialist

OSS Health
Job Description
Under the direction of the Occupational Health Coordinator and Manager, functions as a liaison between patient (injured worker), patient’s employer, case manager, physicians (and staff) and insurance carriers in regards to Workers’ Compensation related questions and issues. Has knowledge of compliance and regulatory issues related to Workers’ Compensation, ensuring highest level of communication and customer service to all involved parties.

Qualifications and Education: 
  • Associates Degree in related field or equivalent level of experience strongly preferred. High School diploma or equivalent required.
 
Qualification:
  • General computer software knowledge required.
  • Excellent organization, problem-solving and communication skills required.
  • Level I:
    • At least one year of Workers’ Compensation or related experience required.
    • Basic working knowledge of Workers’ Compensation law, requirements and protocols required.
    • Basic knowledge of the needs of the employer and insurer.
    • Basic knowledge and understanding of medical terminology.
  • Level II:
    • At least three years of Workers’ Compensation experience required.
    • Detailed knowledge of Workers’ Compensation law, requirements and protocols required.
    • Comprehensive knowledge of the needs of the employer and insurer.
    • Comprehensive knowledge and understanding of medical terminology.
 
Essential Duties and Responsibilities:
  • Facilitates case management for injured workers currently being treated by OSS Health.
    • Communicates with WC carriers for verification of claims
    • Obtains out-of-state authorizations for treatment prior to appointments
    • Maintains WC information on patient chart
    • Maintains open communication with employers relating to the status of injured workers, return-to-work, work restrictions and light duty options
    • Acts as mediator between employer, WC carrier, employee/patient and OSS staff
    • Communicates with appropriate staff on any updates or changes to patient account/record in a timely manner
    • Communicates with patient accounts department regarding denials and changes within accounts for WC patients
  • Returns voicemail and email inquiries in a timely manner.
  • Maintains patient confidentiality at all times.
  • Facilitates communication with companies in the area to promote OSS as a panel provider for work related injuries.  Maintains panel of WC companies.
  • Level II will perform the below in addition to the duties listed above:
    • Exercises sound, independent judgment in decision-making.
    • Analyzes and interprets complex workers’ compensation cases.
    • Initiates and maintains Department of Labor claim status.
    • Offers input to Occupational Health Coordinator and/or Manager for program growth.
    • Assists with training new clinical hires.
    • Other duties as assigned.
 
Compensation:
  • Schedule:  8:30am to 5pm Monday -Thursday; 8am to 4:30pm
 
How to Apply:
  • To view and apply for our job opportunities, please go to our website osshealth.com and select - Join our Team!
Contact Information

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