O
ORTHOLONESTAR
Workers' Compensation Specialist (2489)
1 month ago
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Important information
Contract type:
Permanent
Location:
Houston, TX, USA
Work mode:
Remote
Published on:
26 September 2026
What they need
| General Job Description |
| Handles verification of injury/claim of all WC patients including auditing medical record for billing accuracy. Responsible for marketing to employers/WC clinics and is the point of contact for adjustors and case managers. |
| ESSENTIAL FUNCTIONS |
| - Call adjustors to verify all new and established WC injuries/claims per protocol - Audit WC appointments for comments/authorization/DWC - Prepare claims and documentation for filing - Point of contact for all adjustors and case managers - Facilitate physician’s use and understanding of ODG - Prepare DWC 73’s & 69’s - Authorization of all WC procedures - Timely Follow up on appeals for unpaid claims utilizing claims maintenance - Advise physicians on dispute cases including initiating Benefit Review Conferences - Remain up to date on DWC rules – including ODG treatment, RTW, Preauthorization and fee guidelines - AR Follow up to ensure claims are paid timely. - All other duties as assigned. |
| QUALIFICATIONS | |
| Education | - High School Diploma |
| Experience | - Three years medical office WC billing experience - Knowledge of Texas Workers’ Comp ODG treatment, RTW and fee guidelines |
| Licensure | |
| Special Skills | - Excellent computer knowledge and skills - Ability to effectively communicate both orally and written - Adequate visual acuity to read written materials - Ability to sit for long periods of time - Problem solving skills - Attention to detail |
| PHYSICAL DEMANDS | |
| - Telephone – with or without headset – constantly - Computer – constantly | |
| ENVIORNMENTAL WORKING CONDITIONS | |
| - Remote in your home with potential request to be in office on occasion. - Continuously handle multiple tasks simultaneously and work as part of a team. - Occasionally perform tedious and exacting work in frustrating conditions. |
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