Workers Compensation Specialist

Do you have an interest in Workers' Compensation? Love helping patients navigate processes and interacting with a variety of people? Join ROC as a Workers' Compensation Specialist! This position will remain posted until filled.

You would assist patients and representatives regarding Workers Compensation claims, providing excellent customer service while helping to move the Workers Compensation process along. The work you do will impact patients dealing with the complexities of Workers' Compensation. Between obtaining authorizations, managing claims, and connecting with various parties, your work will have a significant impact on our patients. Your work is a vital part of helping our patients and providers, building meaningful relationships along the way.

ROC is expanding with two more operating suites opening the beginning of 2025 as we welcome nine new surgeons to our team. Join our team to be part of the growth and excitement!

What would you do as a Workers' Compensation Specialist?

The Workers' Compensation Specialist is responsible for processing workers’ compensation claims for our patients and assisting them in the treatment process at our organization.

You can expect to regularly:

• Receive incoming calls from workers’ compensation patients and representatives to answer questions, address concerns, and provide customer service;
• Schedule all internal and external referrals;
• Process all authorizations requests for office procedures, surgeries, Durable Medical Equipment, and office visits.
• Manage requests, claims, and clinical documentation to insurance carriers, adjusters, and nurse case managers;
• Maintain work status daily report for work comp patients;
• Maintain and update patients’ electronic medical records with case data and communication with patient;
• Scan and review all medical records for physician review;
• Receive and address messages promptly and immediately review cancellation and reschedule messages;
• Communicate with MA’s and Physician’s regarding authorization status for surgical procedures and other necessary information; 
• Consult with appropriate resources including but not limited to physicians, servicing agents and legal services regarding the patients Work Compensation cases;
• Correspond with treating physicians, adjusters, attorneys, and injured workers throughout the life of the claim;
• Code correctly all medical orders for injections, testing, and surgeries before going to designated parties, adjusters, nurse case manager, and attorney;
• Work closely with Third-Party Administrators for claims resolution.

• Certifications/Education
• High school diploma/GED;
• Knowledge of
• Gathering and evaluating data;
• Experience
• One year of experience performing customer service duties.

Preferred Qualifications - How can you set yourself apart from other applicants?

• Experience using the electronic medical records system Epic;
• Experience using Microsoft Excel.

This position is for our Main Clinic in Downtown Reno.

Check out our home page by clicking on “View all jobs” to explore the many benefits ROC provides to employees, from medical insurance to paid time off and beyond! This position is eligible for full time benefits and would work a 40-hour per week schedule in our main clinic in downtown Reno.