Coordinator-Medical Review

Department: UHC: Workers Compensation

Job Summary: The Medical Review Coordinator manages the authorization process for work comp specialty and ancillary referrals.  Provide assistance to clinical and front office staff with authorization related issues, assists patients with referral and insurance issues ensuring authorization is obtained for office visits and/or office procedures.  Populates the Workers’ Compensation forms with the history of present illness, medical history, and review of systems.  Drafts the impairment rating for the medical provider’s review.  Performs other duties as needed. 

Education and Experience: High School diploma or GED.  Three years of workers' compensation experience required. Previous editing and historian experience preferred, especially with medical-legal recording to AOE/COE/QME/AME. Authorization procurement experience preferred.

Knowledge and Skills: Intimate knowledge of workers' compensation guidelines and regulations. Knowledge of CPT and ICD codes preferred. In-depth medical terminology knowledge. Able to keyboard 30 wpm. Able to use a computer, printer, and software programs such as Microsoft Office Word and Outlook. Operate/troubleshoot basic office equipment required for the position. Able to work calmly and respond courteously when under pressure; collaborate and accept direction. Able to think critically; manage multiple assignments effectively; organize and prioritize workload; work well under pressure; problem solve; recall information with accuracy; pay close attention to detail; work independently with minimal supervision. Able to distinguish colors as necessary; hear sufficiently for general conversation in person and on the telephone, and identify and distinguish various sounds associated with the workplace; see adequately to read computer screens, and written documents necessary to the position.

Licensures and Certifications: None