Surgical Health Services Coordinator

Position Summary

The Surgical Health Services Coordinator (SHSC) plays a crucial role in the recovery process of workers undergoing surgical procedures. This position serves as a liaison between attending providers, surgical teams, workers, employers, and the Department of Labor and Industries. The SHSC ensures that all aspects of surgical care are efficiently managed, from pre-operative preparation to post-operative follow-up, to facilitate timely and effective recovery.

Key Duties and Responsibilities

The key duties and responsibilities of the Surgical Health Services Coordinator include, but are not limited to:

• Documentation and Compliance: Maintain accurate records. Ensure compliance with HIPAA regulations and L&I documentation requirements.
• Insurance and Billing: Verify patient coverage and collect necessary pre-surgery paperwork. Document all activities in MAVEN SHSC case notes for billing and payment purposes.
• Collaboration: Work closely with surgeons, attending providers, and other healthcare professionals to ensure a seamless surgical process. Act as a point of contact for all parties involved in the worker's care.
• APF Forms and Workers' Comp Paperwork: Assist physicians in completing and uploading Activity Prescription Forms (APF) and other workers' compensation paperwork. Ensure all documentation is accurate and submitted in a timely manner to facilitate the claims process.
• Document Scanning: Scan all relevant documents into the Electronic Medical Records (EMR) system to ensure accurate and up-to-date patient records.
• OHMS Management: Manage and document work in L&I’s web-based Occupational Health Management System (OHMS).
• Risk Identification: Identify claims that are at risk for long-term disability through:
  • Claim-file review
  • Risk measures identified by the SHSC
  • Risk measures identified by OHMS
  • Requests for assistance on the claim from providers, injured workers, employers, or L&I staff.

Other duties as assigned

Education/Experience

• Education: Bachelor's degree or equivalent in a related field.
• Experience: Minimum of three (3) years of experience in direct patient care, return-to-work coordination, workers' compensation claims management, occupational health care, or equivalent experience. Alternatively, seven (7) years of relevant experience without a degree.
• Skills: Strong organizational and communication skills, ability to work collaboratively with diverse teams, and proficiency in medical terminology and healthcare documentation.
• Certifications: Relevant certifications in healthcare coordination or case management are preferred.
• Familiarity with Regulations: Familiarity with Washington State Department of Labor and Industries (L&I) guidelines and regulations.

Key Competencies:

• Attention to Detail: Ensure accuracy in scheduling, documentation, and communication.
• Empathy: Provide compassionate support to patients and their families.
• Problem-Solving: Address and resolve any issues that arise during the surgical process.
• Adaptability: Manage multiple tasks and adapt to changing priorities in a fast-paced environment.

Work Environment/Physical Demands

The work environment/physical demands described here are representative of those that must be met by a teammate to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable differently abled persons to perform the essential functions.